Individual provider Active NPI

Disha Trivedi, MD

  • Nephrology Physician
  • Melbourne, FL
National Provider Identifier
1750522264
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME117749 Issued in FL
Practice address
111 E Hibiscus Blvd
Melbourne, FL 32901-3102
Phone
(321) 768-3655
Fax
(321) 831-3024
NPI assigned
Mar 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME117749 FL Primary

Addresses

Primary practice location

111 E Hibiscus Blvd
Melbourne, FL 32901-3102

Mailing address

111 E Hibiscus Blvd
Melbourne, FL 32901-3102
Phone (321) 768-3655

Other practice location 1

450 Malabar Rd SE Unit 102
Palm Bay, FL 32907-3111
Phone (321) 768-3655

Other practice location 2

14 Suntree Pl Ste 104
Melbourne, FL 32940-7605
Phone (321) 768-3655

Other identifiers 1

IdentifierTypeStateIssuer
105543800MedicaidFL

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
I20141104000989 FL Practitioner - NephrologyPractitioner - Internal Medicine 1254577000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

111 E Hibiscus Blvd
Melbourne, FL 32901-3102
Phone (321) 768-3655

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
93.28
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME117749FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney Physicians , LLC Nephrology CurrentSince Dec 1, 2021 Accepting new patients
Florida Kidney Physicians, LLC Nephrology CurrentSince Feb 1, 2017 Accepting new patients

Locations

850 W Rio Salado Pkwy
Ste 201
Tempe, AZ 85281

1150 N 35th Ave
Ste 620
Hollywood, FL 33021
Phone (954) 612-8173

111 E Hibiscus Blvd
Melbourne, FL 32901
Phone (321) 725-8919

14 Suntree Pl
Ste 104
Melbourne, FL 32940
Phone (321) 768-3655

19056 NE 29th Ave
Miami, FL 33180
Phone (305) 354-4558

450 Malabar Rd SE
Unit 102
Palm Bay, FL 32907
Phone (321) 435-3655

450 Malabar Rd SE
Palm Bay, FL 32907
Phone (321) 752-3888

3221 Tamiami Trl
Pt Charlotte, FL 33952

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4
  • Direct secure messaging: disha.trivedi.1@15644.direct.athenahealth.com
  • Direct secure messaging: dtrivedi71555@epicdirect.hf.org

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 9

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": "1236816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1750522264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E HIBISCUS BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013102",
            "telephone_number": "321-768-3655",
            "fax_number": "321-831-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E HIBISCUS BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013102",
            "telephone_number": "321-768-3655",
            "fax_number": "321-831-3024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Malabar Rd SE Unit 102",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329073111",
            "country_code": "US",
            "telephone_number": "321-768-3655",
            "fax_number": "321-831-3024",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14 Suntree Pl Ste 104",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329407605",
            "country_code": "US",
            "telephone_number": "321-768-3655",
            "fax_number": "321-831-3024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRIVEDI",
        "first_name": "DISHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-12",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME117749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105543800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.