Individual provider Active NPI

Reut Bardach, M,D.

  • Obstetrics & Gynecology Physician
  • Trinity, FL
National Provider Identifier
1780950527
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME111975 Issued in FL
Practice address
2043 Little Rd
Trinity, FL 34655
Phone
(727) 846-7000
Fax
(877) 260-1182
NPI assigned
Mar 27, 2012
Last updated
Sep 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME111975 FL Primary

Addresses

Primary practice location

2043 Little Rd
Trinity, FL 34655

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (727) 376-3798

Other identifiers 2

IdentifierTypeStateIssuer
004662800MedicaidFL
OD543OtherFLMEDICARE HF

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
I20120716000251 FL Practitioner - Obstetrics/Gynecology 5092971200 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians

Practice addresses (Care Compare)

2043 Little Rd
Trinity, FL 34655-4421
Phone (727) 846-7000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Florida, LLC CurrentSince Jan 1, 2025 Accepting new patients
Community Hospital Family Practice LLC CurrentSince Aug 1, 2015 Accepting new patients

Locations

7515 State Road 52
Ste 102
Hudson, FL 34667
Phone (727) 842-3322

140 6th Ave
Indialantic, FL 32903
Phone (321) 312-3501

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958
Phone (727) 617-1777

2043 Little Rd
Trinity, FL 34655
Phone (727) 375-2222

9332 State Road 54
Ste 406
Trinity, FL 34655
Phone (727) 376-3798

11375 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 596-4209

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rbardach@obwgp-fl.direct.office.nextgen.com
  • Direct secure messaging: reut.bardach.1@8042.direct.athenahealth.com

Organizations & group practices 4

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 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": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1780950527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "727-376-3798",
            "fax_number": "727-375-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "34655",
            "telephone_number": "727-846-7000",
            "fax_number": "877-260-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDACH",
        "first_name": "REUT",
        "credential": "M,D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME111975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004662800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HF",
            "identifier": "OD543",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

Verify at the official NPI Registry.