Gnaneswara V Midathala, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME109325 Issued in FL

Practice address

3130 SW 27TH Ave
Ocala, FL 34471-4306

Phone

(352) 547-2097

NPI assigned

Aug 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Baycare Behavioral Health Associates LLC

  • Psychiatry Physician
  • Lutz, FL
  • NPI 1245502152
  Medicare reassignment NPD
• Hni Medical Services of Florida, LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1679048284

  Psychiatry

  Medicare reassignment NPD
• Winter Haven Hospital Inc

  • General Acute Care Hospital
  • Winter Haven, FL
  • NPI 1477599975
  Medicare reassignment NPD
• Baycare Behavioral Health Associates LLC

  • Psychiatry Physician
  • Clearwater, FL
  • NPI 1952856858
  NPD

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1750393237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100183",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100183",
            "telephone_number": "352-392-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 SW 27TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714306",
            "telephone_number": "352-547-2097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8225 State Road 54",
            "address_purpose": "LOCATION",
            "city": "New Port Richey",
            "state": "FL",
            "postal_code": "346553016",
            "country_code": "US",
            "telephone_number": "309-310-4399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326104306",
            "country_code": "US",
            "telephone_number": "352-392-0140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Patewood Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296156317",
            "country_code": "US",
            "telephone_number": "864-455-8988",
            "fax_number": "864-522-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIDATHALA",
        "first_name": "GNANESWARA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036092506",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "86855",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME109325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mid-Florida Endoscopy & Surgery Center LLC
• Deanna May Middleton
• Midstate Neurology
• Midstate Skin Institute, LLC
• Midway Group Home (Dba)
• Joseph Paul Migliore, DO

• Psychiatry Physician in Ocala, FL
• Providers in Ocala, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.