George A Idiculla, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0066869 Issued in FL

Practice address

1029 Florida Ave S
Rockledge, FL 32955-2160

Phone

(321) 638-0888

Fax

(321) 638-0830

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Health First Home Care Home health agency, Melbourne, FL, CCN 107233
• Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177
• Viera Hospital Hospital, Melbourne, FL, CCN 100315

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.

• George Idiculla MD,PA

  • Internal Medicine Physician
  • Rockledge, FL
  • NPI 1013289859
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cape Canaveral Hospital, Inc.

  • General Acute Care Hospital
  • Cocoa Beach, FL
  • NPI 1184691610
  Care Compare affiliation
• Cape Canaveral Hospital, Inc.

  • Home Health Agency
  • Melbourne, FL
  • NPI 1922006956
  Care Compare affiliation
• Viera Hospital Inc

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1730494816
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375142400000",
    "number": "1891806642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 FLORIDA AVE S",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552160",
            "telephone_number": "321-638-0888",
            "fax_number": "321-638-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 FLORIDA AVE S",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552160",
            "telephone_number": "321-638-0888",
            "fax_number": "321-638-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDICULLA",
        "first_name": "GEORGE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0066869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376630600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Huntington Place Limited Partnership
• Hurley Health Center LLC
• Christy Hyde, MA CCC/SLP
• I'M All Ears LLC
• Iamwhereigrow, LLC
• Frank Imas, M.D.
• Christina L Ingram, RBT
• Sarah Inman, RN, IBCLC
• Internal Medicine of Brevard, PLLC
• Interventional Spine Institute of Florida

• Internal Medicine Physician in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; 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.

Verify at the official NPI Registry.