NPIMap

Organization Active NPI

Nibha Mediratta MD PL

  • Internal Medicine Physician
  • Clermont, FL
National Provider Identifier
1629387980
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME95217 Issued in FL
Legal business name
NIBHA MEDIRATTA MD PL
Practice address
1950 Hospital View Way
Clermont, FL 34711-1926
Phone
(352) 243-3443
Fax
(352) 243-3044
NPI assigned
Oct 4, 2010
Last updated
Apr 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Nibha Mediratta, MDNPI 1275584369
Title
Owner
Phone
(321) 274-1864

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME95217 FL Primary

Addresses

Primary practice location

1950 Hospital View Way
Clermont, FL 34711-1926

Mailing address

PO Box 991
Gotha, FL 34734-0985
Phone (321) 274-1864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101117000124 FL Part B Supplier - Clinic/Group Practice 6507051406 Receives reassigned benefits from 8 practitioners
Practice locations: Clermont, FL

National Provider Directory

National Provider Directory

Locations

1970 Hospital View Way
Clermont, FL 34711
Phone (321) 274-1864

1970 Hospital View Way
Ste 1
Clermont, FL 34711
Phone (352) 243-1101

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BEBDAD

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586131200000",
    "number": "1629387980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 991",
            "city": "GOTHA",
            "state": "FL",
            "postal_code": "347340985",
            "telephone_number": "321-274-1864",
            "fax_number": "352-243-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 HOSPITAL VIEW WAY",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111926",
            "telephone_number": "352-243-3443",
            "fax_number": "352-243-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIBHA MEDIRATTA MD PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-04",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A",
        "authorized_official_last_name": "MEDIRATTA",
        "authorized_official_first_name": "NIBHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-274-1864",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME95217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.