NPIMap

Individual provider Active NPI

Gobivenkata Balaji, MD

  • Internal Medicine Physician
  • Melbourne, FL
National Provider Identifier
1649230459
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME77839 Issued in FL
Practice address
298 Michigan Ave
Suite 101
Melbourne, FL 32901-3104
Phone
(321) 215-6899
Fax
(321) 215-6789
NPI assigned
Mar 24, 2006
Last updated
Mar 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME77839 FL Primary

Addresses

Primary practice location

298 Michigan Ave
Suite 101
Melbourne, FL 32901-3104

Mailing address

298 Michigan Ave
Suite 101
Melbourne, FL 32901-3104
Phone (321) 215-6899

Other identifiers 2

IdentifierTypeStateIssuer
257850600MedicaidFL
110199177OtherFLRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100205000189 FL Practitioner - Internal Medicine 3678616133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brevard Health Center PLGroup PAC ID 6901939735, 3 clinicians
H2 Rehabilitation Services of Florida LLCGroup PAC ID 3971411851, shared by 10 NPIs, 257 clinicians

Practice addresses (Care Compare)

298 Michigan Ave
Melbourne, FL 32901-3104
Phone (321) 215-6899

3680 N Wickham Rd
Suite B
Melbourne, FL 32935-2327
Phone (321) 255-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Health Center PL Internal Medicine CurrentSince May 20, 2010 Accepting new patients
Cardiac Imaging Inc CurrentSince Nov 4, 2025 Accepting new patients
Osler Medical Inc Past Accepting new patients

Locations

298 Michigan Ave
Ste 101
Melbourne, FL 32901
Phone (321) 215-6899

Interoperability endpoints

  • Direct secure messaging: gbalaji23002@epicdirect.hf.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1649230459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 MICHIGAN AVE",
            "address_2": "SUITE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013104",
            "telephone_number": "321-215-6899",
            "fax_number": "321-215-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 MICHIGAN AVE",
            "address_2": "SUITE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013104",
            "telephone_number": "321-215-6899",
            "fax_number": "321-215-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALAJI",
        "first_name": "GOBIVENKATA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME77839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257850600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110199177",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.