NPIMap

Individual provider Active NPI

Yvette Marie Lopez-Granberry, M.D.

  • Internal Medicine Physician
  • Melbourne, FL
National Provider Identifier
1750384772
Registry record updated Mar 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME59258 Issued in FL
Practice address
6300 N Wickham Rd
Ste 101
Melbourne, FL 32940-2023
Phone
(321) 253-2169
Fax
(321) 253-1720
NPI assigned
May 23, 2005
Last updated
Mar 22, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2013

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 ME59258 FL Primary

Addresses

Primary practice location

6300 N Wickham Rd
Ste 101
Melbourne, FL 32940-2023

Mailing address

456 Prestwick CT
Melbourne, FL 32940-1876
Phone (321) 254-2016

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
I20041216000725 FL Practitioner - Internal Medicine 3375504004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ponce School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
D Badolato PAGroup PAC ID 1557322286, 8 clinicians

Practice addresses (Care Compare)

6300 N Wickham Rd
Suite 101
Melbourne, FL 32940-2023
Phone (321) 253-2169

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
D Badolato PA CurrentSince Sep 20, 2004 Accepting new patients
Premier Urgent Care of Brevard LLC Past Accepting new patients

Locations

6300 N Wickham Rd
Ste 101
Melbourne, FL 32940
Phone (321) 253-2169

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1750384772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 PRESTWICK CT",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401876",
            "telephone_number": "321-254-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 N WICKHAM RD",
            "address_2": "STE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402023",
            "telephone_number": "321-253-2169",
            "fax_number": "321-253-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-GRANBERRY",
        "first_name": "YVETTE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME59258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.