NPIMap

Individual provider Active NPI

Gopi Kiran Maharaja, MD

  • General Practice Physician
  • Davenport, FL
National Provider Identifier
1649568288
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME12604412 Issued in FL
Practice address
106 Park Place Blvd Ste C
Davenport, FL 33837-6868
Phone
(863) 588-4775
Fax
(863) 422-7664
NPI assigned
Jul 18, 2011
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME12604412 FL Primary

Addresses

Primary practice location

106 Park Place Blvd Ste C
Davenport, FL 33837-6868

Mailing address

PO Box 878
Davenport, FL 33836-0878
Phone (689) 223-3898

Other practice location 1

17075 Cagan Ridge Blvd Ste 100
Clermont, FL 34714-9619
Phone (863) 588-4775

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
I20160316000477 FL Practitioner - General PracticePractitioner - Internal Medicine 6901102078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Soni Family Practice PLLCGroup PAC ID 8224274840, 11 clinicians

Practice addresses (Care Compare)

106 Park Place Blvd
Suite C
Davenport, FL 33837-6868
Phone (863) 588-4775

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Adventhealth Heart of Florida Hospital, Davenport, FL, CCN 100137
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME12604412FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Soni Family Practice, PLLC CurrentSince May 1, 2019 Accepting new patients
SFP PC Holdings, Inc. CurrentSince Jun 15, 2025 Accepting new patients

Locations

17075 Cagan Ridge Blvd
Ste 100
Clermont, FL 34714

17075 Cagan Ridge Blvd
#100A
Clermont, FL 34714

106 Park Place Blvd
Ste C
Davenport, FL 33837
Phone (863) 422-7664

2705 Maguire Rd
Ocoee, FL 34761
Phone (407) 574-2880

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: gopi.maharaja.1@6807.direct.athenahealth.com

Organizations & group practices 2

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

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1649568288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 878",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338360878",
            "telephone_number": "689-223-3898",
            "fax_number": "689-223-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 PARK PLACE BLVD STE C",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338376868",
            "telephone_number": "863-588-4775",
            "fax_number": "863-422-7664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17075 Cagan Ridge Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347149619",
            "country_code": "US",
            "telephone_number": "863-588-4775",
            "fax_number": "863-422-7664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHARAJA",
        "first_name": "GOPI",
        "middle_name": "KIRAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "U",
        "enumeration_date": "2011-07-18",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME12604412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.