Individual provider Active NPI

Rahul Bhalla, MD

  • General Practice Physician
  • Clermont, FL
National Provider Identifier
1730826900
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME173109 Issued in FL
Practice address
17075 Cagan Ridge Blvd Ste 100
Clermont, FL 34714-9619
Phone
(863) 588-4775
Fax
(863) 422-7664
NPI assigned
May 18, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME173109 FL
Family Medicine Physician 207Q00000X 125.079765 IL
General Practice Physician 208D00000X ME173109 FL Primary

Addresses

Primary practice location

17075 Cagan Ridge Blvd Ste 100
Clermont, FL 34714-9619

Mailing address

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

Other practice location 1

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

Other practice location 2

600 Roe Ave
Elmira, NY 14905-1629
Phone (607) 737-4100

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
I20251120004511 FL Practitioner - General PracticePractitioner - Family Practice 9931580503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2020
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)

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

Hospital & facility affiliations

  • Adventhealth Heart of Florida Hospital, Davenport, FL, CCN 100137

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.079765ILMDFamily Medicine Physician
ME173109FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Soni Family Practice, PLLC Family Medicine CurrentSince Dec 1, 2025 Accepting new patients
SFP PC Holdings, Inc. CurrentSince Dec 1, 2025 Accepting new patients

Locations

17075 Cagan Ridge Blvd
Ste 100
Clermont, FL 34714

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

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rbhallamd349796@carlehiedirect.net
  • Direct secure messaging: rahul.bhalla.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 1

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": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1730826900",
    "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": "17075 CAGAN RIDGE BLVD STE 100",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347149619",
            "telephone_number": "863-588-4775",
            "fax_number": "863-422-7664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Park Place Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "FL",
            "postal_code": "338376868",
            "country_code": "US",
            "telephone_number": "863-588-4775",
            "fax_number": "863-422-7664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Roe Ave",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "NY",
            "postal_code": "149051629",
            "country_code": "US",
            "telephone_number": "607-737-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHALLA",
        "first_name": "RAHUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-18",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME173109",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.079765",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME173109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.