Active NPI
Adwait H Jathal, M.D.
- Gastroenterology Physician
- Melbourne, FL
National Provider Identifier
1972574333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- ME96379
- Practice address
- 200 Michigan Ave
Melbourne, FL 32901-3100 - Phone
- (321) 952-0700
- Fax
- (321) 952-4444
- NPI assigned
- Feb 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | ME96379 | FL | Primary |
Addresses
Primary practice location
200 Michigan Ave
Melbourne, FL 32901-3100
Mailing address
200 Michigan Ave
Melbourne, FL 32901-3100
Phone (321) 952-0700
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1378963 | Other | FL | AETNA |
| 293711 | Other | FL | WELLCARE |
| 56422 | Other | FL | BLUE CROSS BLUE SHIELD |
| 276213700 | Medicaid | FL | |
| 7863816 | Other | FL | AETNA |
| 2769681002 | Other | FL | CIGNA |
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
- Gastroenterology
- Education
- Loyola University of Chicago, Stritch School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Michigan Ave
Melbourne, FL 32901-3100
Phone (321) 952-0700
Hospital & facility affiliations
- Viera Hospital
- Adventhealth Orlando
- Holmes Regional Medical Center
- Palm Bay Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 368 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 100 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME96379 | FL | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Associates of Brevard LLC | Current | Accepting new patients |
Locations
1305 Hickory St
Melbourne, FL 32901
Phone (321) 255-1500
200 Michigan Ave
Melbourne, FL 32901
Phone (321) 543-8703
1380 South Patrick Dr
Satellite Beach, FL 32937
Phone (321) 313-0633
Interoperability endpoints
- adwaitjathal@mab.medentdirect.com
- ajathal71502@epicdirect.hf.org
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Melbourne, FL
- NPI 1861400103
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
-
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
-
- General Acute Care Hospital
- Palm Bay, FL
- NPI 1386940823
-
- General Acute Care Hospital
- Melbourne, FL
- NPI 1295702728
-
- 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": "1138752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447113600000",
"number": "1972574333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 MICHIGAN AVE",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013100",
"telephone_number": "321-952-0700",
"fax_number": "321-952-4444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MICHIGAN AVE",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013100",
"telephone_number": "321-952-0700",
"fax_number": "321-952-4444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JATHAL",
"first_name": "ADWAIT",
"middle_name": "H",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-01",
"last_updated": "2015-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "ME96379",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "1378963",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "293711",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "56422",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "276213700",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7863816",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2769681002",
"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 Nov 10, 2015; 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.