Active NPI
Evangelia Fotopoulos, M.D.
- Family Medicine Physician
- Melbourne, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME112559
- Practice address
- 2222 S Harbor City Blvd
Suite 430
Melbourne, FL 32901-5594 - Phone
- (321) 541-1777
- Fax
- (321) 725-5504
- NPI assigned
- Dec 17, 2009
- Last updated
- Jan 4, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | L.3075R | AL | |
| Family Medicine Physician | 207Q00000X | ME112559 | FL | Primary |
Addresses
Primary practice location
2222 S Harbor City Blvd
Suite 430
Melbourne, FL 32901-5594
Mailing address
2222 S Harbor City Blvd
Ste 440
Melbourne, FL 32901-5591
Phone (321) 541-1744
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005580100 | Medicaid | FL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
417 5TH Ave
Apt 101
Indialantic, FL 32903-4224
Phone (321) 615-6569
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L.3075R | AL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steward Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Steward Medical Group, Inc | Current | Accepting new patients | |
| RHG of Florida PA | Family Medicine | Current | Accepting new patients |
Locations
2222 S Harbor City Blvd
Ste 420
Melbourne, FL 32901
Phone (321) 768-9914
2222 S Harbor City Blvd
Ste 430
Melbourne, FL 32901
Phone (321) 344-8746
2222 S Harbor City Blvd
Ste 440
Melbourne, FL 32901
Phone (321) 541-1744
240 N Wickham Rd
Ste 204
Melbourne, FL 32935
Phone (321) 751-1801
240 N Wickham Rd
Ste 304
Melbourne, FL 32935
Phone (321) 308-5050
7754 Bay St
Ste 67
Sebastian, FL 32958
Phone (772) 589-3000
8000 Ron Beatty Blvd
Ste A-3
Sebastian, FL 32976
Phone (772) 664-1388
Interoperability endpoints
- evangelia.fotopoulos.1@15594.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.
-
- Family Medicine Physician
- Sebastian, FL
- NPI 1932926169
-
- Family Medicine Physician
- Indialantic, FL
- NPI 1689928590
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba First Flight
- Air Ambulance
- Melbourne, FL
- NPI 1235312281
Hospital
-
- General Acute Care Hospital
- Melbourne, FL
- NPI 1295702728
-
dba Orlando Health Melbourne Hospital
- General Acute Care Hospital
- Melbourne, FL
- NPI 1033937883
-
- General Acute Care Hospital
- Melbourne, FL
- NPI 1730494816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483488000000",
"number": "1790014942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 S HARBOR CITY BLVD",
"address_2": "STE 440",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329015591",
"telephone_number": "321-541-1744",
"fax_number": "321-725-4183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 S HARBOR CITY BLVD",
"address_2": "SUITE 430",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329015594",
"telephone_number": "321-541-1777",
"fax_number": "321-725-5504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOTOPOULOS",
"first_name": "EVANGELIA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-17",
"last_updated": "2017-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "L.3075R",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME112559",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005580100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.