CRAIG J BADOLATO MD
NPI 1013998970
Internal Medicine - Hematology & Oncology in Melbourne, FL

Q: What is Craig Badolato's NPI number?

The NPI number for Craig Badolato is 1013998970. It was assigned to this individual provider in the NPPES registry on November 8, 2005.

Q: What is Craig Badolato's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Q: When was this NPI record last updated?

The NPPES record for Craig Badolato was last updated on April 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 08, 2005PECOS EnrolledAccepts Medicare Assignment

98.27/100

CMS Quality Rating

1430 PINE ST, MELBOURNE, FL 32901(321) 674-5050(321) 952-6296 Get Directions Write a Review

NPPES record last updated: April 26, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 26, 2019, Jan 7, 2019 (2 updates tracked since 2019).

On this page

About Craig J Badolato Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRAIG J BADOLATO MD (NPI 1013998970) is an individual hematology & oncology provider in Melbourne, Florida, licensed in Florida (ME61815) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Holmes Regional Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1013998970

Entity TypeIndividualMale

Primary Taxonomy207RH0003X

Provider Legal NameCRAIG J BADOLATOCredential: MD

Location Address1430 PINE STMelbourne, FL 32901-3119

Mailing AddressPo Box 534595Atlanta, GA 30353-4595 · (321) 636-2111 · Fax (321) 636-7180

Phone(321) 674-5050

Fax(321) 952-6296

Sole ProprietorNo

Medical School CMSHahnemann University College Of MedicineGraduated 1986

Enumeration DateNovember 8, 2005

Last NPPES UpdateApril 26, 20192 updates tracked since enumeration

✔ NPI 1013998970 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in FL · ME61815

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

1430 PINE ST, Melbourne, FL 32901

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Secondary Practice Locations 2

Location 1107 Longwood AveRockledge, FL 32955-2827 · Phone (321) 636-2111 · Fax (321) 636-7180

Location 21048 Harvin WayRockledge, FL 32955-3229 · Phone (321) 636-2111 · Fax (321) 636-7180

Other Identifiers 7

Other03714FL · Wellcare

Other808490001FL · Cigna

Other15118FL · Blue Cross Blue Shield

Medicaid373692000FL

Other110067794FL · Railroad Medicare

Other4268178FL · Aetna

Other667172FL · Aetna

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Craig J Badolato Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739086570

PECOS Enrollment IDI20091019000111

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 15

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, denosumab, 1 mg J0897

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

8,100 services35 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

890 services11 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

795 services261 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

617 services265 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

587 services237 patients

Administration of chemotherapy into vein, 1 hour or less 96413

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

309 services38 patients

Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less 96367

This procedure involves injecting fluids or medication directly into your vein. It's used for treatment, prevention, or diagnosis. An additional sequential infusion may be given within an hour if needed. This helps to ensure the medicine is distributed effectively in your body.

175 services21 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

171 services44 patients

Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle 96401

This procedure involves giving anti-cancer drugs, which don't contain hormones, into the muscle or under the skin. These drugs help to stop the growth of cancer cells. The process is usually quick and done by a healthcare professional.

168 services11 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle 96402

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

104 services14 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

87 services87 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

57 services20 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

36 services31 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

29 services26 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

14 services14 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Holmes Regional Medical Center

Acute Care Hospitals · Melbourne, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100019

Location1350 S Hickory StMelbourne, FL 32901 · Brevard County

Emergency services Birthing friendly

Melbourne Regional Medical Center

Acute Care Hospitals · Melbourne, FL

2/5 CMS rating

OwnershipProprietary

CMS Certification Number100291

Location250 North Wickham RoadMelbourne, FL 32935 · Brevard County

Emergency services

Viera Hospital

Acute Care Hospitals · Melbourne, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100315

Location8745 N Wickham RdMelbourne, FL 32940 · Brevard County

Emergency services

Palm Bay Hospital

Acute Care Hospitals · Palm Bay, FL

4/5 CMS rating

OwnershipProprietary

CMS Certification Number100316

Location1425 Malabar Rd, NEPalm Bay, FL 32907 · Brevard County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$171.84 typical visit price

range $56.00 – $171.84

Typical copayment $42.96 (range $14.00 – $42.96)

Most-billed visit code 99205

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.27/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

89.77

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report

72%71 patients4/55-star benchmark: 87%

Documentation of Current Medications in the Medical Record

95%2,901 patients4/55-star benchmark: 100%

Oncology: Medical and Radiation - Pain Intensity Quantified

98%747 patients4/55-star benchmark: 100%

Oncology: Medical and Radiation - Plan of Care for Pain

100%164 patients5/55-star benchmark: 100%

Oncology: Patient-Reported Pain Improvement

54%110 patients

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

12%1,058 patients1/55-star benchmark: 97%

Provide Patients Electronic Access to Their Health Information

97%460 patients4/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

1%640 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers34 claims34 services$13.70 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers34 claims34 services$65.76 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAVI SHANKAR MD

Radiology (Radiation Oncology)

1430 PINE ST
MELBOURNE, FL 32901

Brevard County (321) 952-0898

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Craig Badolato's NPI number?

The NPI number for Craig Badolato is 1013998970. It was assigned to this individual provider in the NPPES registry on November 8, 2005.

Where is Craig Badolato located?

Craig Badolato practices at 1430 Pine St, Melbourne, FL 32901. The listed phone number is (321) 674-5050.

What is Craig Badolato's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Craig Badolato enrolled in Medicare?

Yes. Craig Badolato is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Craig Badolato accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 3 other insurers list Craig Badolato as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Craig Badolato affiliated with any hospitals?

According to CMS data, Craig Badolato is affiliated with Holmes Regional Medical Center, Melbourne Regional Medical Center, Viera Hospital and Palm Bay Hospital.

When was this NPI record last updated?

The NPPES record for Craig Badolato was last updated on April 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.