Individual provider Active NPI

Charles B Barniv, M.D.

  • Family Medicine Physician
  • Destin, FL
National Provider Identifier
1932309937
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME43565 Issued in FL
Practice address
623 Harbor Blvd Ste 3
Destin, FL 32541-2436
Phone
(850) 837-5181
Fax
(850) 654-1947
NPI assigned
Jul 19, 2007
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME43565 FL Primary

Addresses

Primary practice location

623 Harbor Blvd Ste 3
Destin, FL 32541-2436

Mailing address

2675 Winkler Ave FL 2Floor
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other identifiers 1

IdentifierTypeStateIssuer
46152OtherFLBCBS

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
I20101014000022 FL Practitioner - Family Practice 0446442065 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Family Medicine CurrentSince Feb 11, 2020 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Feb 11, 2020 Accepting new patients

Locations

14540 Cortez Blvd
Ste 102
Brooksville, FL 34613
Phone (352) 596-7255

623 Highway 98 E
Ste 3
Destin, FL 32541
Phone (850) 837-5181

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Organizations & group practices 3

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": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1932309937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2FLOOR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 HARBOR BLVD STE 3",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412436",
            "telephone_number": "850-837-5181",
            "fax_number": "850-654-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNIV",
        "first_name": "CHARLES",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME43565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "46152",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

Verify at the official NPI Registry.