NPIMap

Organization Active NPI

Srinivas Dontineni MD PA

Doing business as Brevard Hospitalist Associates

  • Infectious Disease Physician
  • Cocoa, FL
National Provider Identifier
1639323041
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
SRINIVAS DONTINENI MD PA
Doing business as
Brevard Hospitalist Associates
Practice address
2428 Clearlake Rd BLDG K
Cocoa, FL 32922-5722
Phone
(321) 368-3862
Fax
(321) 208-8717
NPI assigned
Nov 12, 2008
Last updated
Jan 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Authorized official

Name
Dr. Srinivas Rao Dontineni, MDNPI 1669467155
Title
Internal Medicine Physician
Phone
(321) 751-9506

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
Infectious Disease Physician 207RI0200X Primary

Addresses

Primary practice location

2428 Clearlake Rd BLDG K
Cocoa, FL 32922-5722

Mailing address

PO Box 560059
Rockledge, FL 32956-0059
Phone (321) 368-3862

Other identifiers 2

IdentifierTypeStateIssuer
004793700MedicaidFL
BM919AOtherFLMEDICARE PTAN

Other names 1

  • Brevard Hospitalist Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090331000553 FL Part B Supplier - Clinic/Group Practice 3375600612 Receives reassigned benefits from 10 practitioners
Practice locations: Cocoa, FL

National Provider Directory

National Provider Directory

Locations

2800 Aurora Rd
Ste F
Melbourne, FL 32935
Phone (321) 368-3862

6550 N Wickham Rd
Ste 2
Melbourne, FL 32940
Phone (321) 259-3911

Practitioners & affiliated clinicians

Practitioners 11

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": "1226448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1639323041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560059",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329560059",
            "telephone_number": "321-368-3862",
            "fax_number": "321-208-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 CLEARLAKE RD BLDG K",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329225722",
            "telephone_number": "321-368-3862",
            "fax_number": "321-208-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRINIVAS DONTINENI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-12",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "DONTINENI",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_middle_name": "RAO",
        "authorized_official_title_or_position": "INTERNAL MEDICINE PHYSICIAN",
        "authorized_official_telephone_number": "321-751-9506",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004793700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BM919A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brevard Hospitalist Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brevard Hospitalist Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cocoa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.