Individual provider Active NPI

Srinivas Rao Dontineni, MD

  • Internal Medicine Physician
  • Cocoa, FL
National Provider Identifier
1669467155
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME88036 Issued in FL
Practice address
2428 Clearlake Rd BLDG K
Cocoa, FL 32922-5722
Phone
(321) 368-3862
Fax
(321) 208-8717
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
Yes

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME88036 FL 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) 795-6380

Other practice location 1

1264 Malabar Rd SE
Palm Bay, FL 32907-2556
Phone (321) 726-6464

Other identifiers 2

IdentifierTypeStateIssuer
82027OtherFLBLUE CROSS BLUE SHIELD
268191900MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031231000098 FL Practitioner - Infectious DiseasePractitioner - Internal Medicine 5092614891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
R Franklin University of Med & Sci/Chicago Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Srinivas Dontineni, MD, PAGroup PAC ID 3375600612, 7 clinicians

Practice addresses (Care Compare)

2428 Clearlake Rd
BLDG K
Cocoa, FL 32922-5722
Phone (321) 368-3862

Hospital & facility affiliations

  • Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
  • Palm Bay Hospital Hospital, Palm Bay, FL, CCN 100316

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59 LLC CurrentSince Jun 12, 2018 Accepting new patients
KND Development 59, LLC CurrentSince Jun 12, 2018 Accepting new patients
Madhavi Chary LLC Internal Medicine CurrentSince Jul 12, 2020 Accepting new patients
Srinivas Dontineni MD PA Internal Medicine CurrentSince Nov 1, 2008 Accepting new patients
Rockledge Hospitalist Services LLC Past Accepting new patients

Locations

2428 Clearlake Rd
Bldg K
Cocoa, FL 32922
Phone (321) 368-3862

250 N Wickham Rd
Melbourne, FL 32935
Phone (321) 637-2600

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

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

3030 6th St S
St Petersburg, FL 33705
Phone (727) 894-8719

4555 S Manhattan Ave
Tampa, FL 33611
Phone (813) 540-0093

Interoperability endpoints

  • Direct secure messaging: sdontineni71594@epicdirect.hf.org

Organizations & group practices 5

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 3

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1669467155",
    "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": "321-795-6380",
            "fax_number": "321-208-8515"
        },
        {
            "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": [
        {
            "address_1": "1264 Malabar Rd SE",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329072556",
            "country_code": "US",
            "telephone_number": "321-726-6464",
            "fax_number": "321-725-3244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONTINENI",
        "first_name": "SRINIVAS",
        "middle_name": "RAO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME88036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "82027",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268191900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

Verify at the official NPI Registry.