Individual provider Active NPI

Sridhar Reddy Goli, M.D.,

  • Pediatric Gastroenterology Physician
  • Orlando, FL
National Provider Identifier
1851528103
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
ME124610 Issued in FL
Practice address
615 E Princeton St Ste 401
Orlando, FL 32803
Phone
(407) 303-9926
Fax
(407) 303-9928
NPI assigned
Jun 14, 2009
Last updated
Jul 23, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X ME124610 FL Primary

Addresses

Primary practice location

615 E Princeton St Ste 401
Orlando, FL 32803

Mailing address

1507 S Hiawassee Rd Ste 105
Orlando, FL 32835-5706
Phone (407) 445-9224

Other identifiers 1

IdentifierTypeStateIssuer
015728700MedicaidFL

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
I20180306001160 FL Practitioner - GastroenterologyPractitioner - Pediatric Medicine 1759504764 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Pediatric Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

615 E Princeton St
Suite 401
Orlando, FL 32803-1469
Phone (407) 303-9926

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Aug 5, 2018 Accepting new patients
The Nemours Foundation CurrentSince Jul 23, 2017 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Aug 5, 2018 Accepting new patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Jul 23, 2017 Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

2400 N Orange Blossom Trl
Ste 302
Kissimmee, FL 34744
Phone (407) 932-6193

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

615 E Princeton St
Ste 225
Orlando, FL 32803
Phone (407) 303-9926

615 E Princeton St
Ste 401
Orlando, FL 32803
Phone (407) 303-9194

8331 N Davis Hwy
Spc Care
Pensacola, FL 32514
Phone (850) 505-4700

2200 Fowler Grove Blvd
Ste 200
Winter Garden, FL 34787
Phone (407) 271-3607

Interoperability endpoints

  • Direct secure messaging: sgoli73133@adventhealth.direct-ci.com
  • Direct secure messaging: sridhar.goli@direct.carepointhealth.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1244937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1851528103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 S HIAWASSEE RD STE 105",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355706",
            "telephone_number": "407-445-9224",
            "fax_number": "407-445-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON ST STE 401",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32803",
            "telephone_number": "407-303-9926",
            "fax_number": "407-303-9928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLI",
        "first_name": "SRIDHAR",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-14",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME124610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015728700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.