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RIDGE MANOR FAMILY CLINIC INC
NPI 1730577115
General Practice in Brooksville, FL

Active since January 07, 2015
12204 CORTEZ BLVD, BROOKSVILLE, FL 34613(352) 799-3449(352) 799-3214 Get Directions Write a Review

NPPES record last updated: February 10, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ridge Manor Family Clinic Inc NPPES

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

RIDGE MANOR FAMILY CLINIC INC (NPI 1730577115) is a healthcare organization registered as a general practice in Brooksville, Florida and active in the NPI registry since January 2015. The organization lists Gopal R Korupolu, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1730577115
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameRIDGE MANOR FAMILY CLINIC INC
Location Address12204 CORTEZ BLVDBrooksville, FL 34613-2630
Mailing AddressPo Box 15781Brooksville, FL 34604-0124 · (352) 799-3449 · Fax (352) 799-3214
Phone(352) 799-3449
Fax(352) 799-3214
Organization SubpartNo
Authorized OfficialGopal R KorupoluPhysician/owner · (352) 799-3449
Enumeration DateJanuary 7, 2015
Last NPPES UpdateFebruary 10, 2015
✔ NPI 1730577115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in FL · ME0070951
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
12204 CORTEZ BLVD, Brooksville, FL 34613
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Other Identifiers 1

Medicare UPING33704FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ridge Manor Family Clinic Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Ridge Manor Family Clinic Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Gopal Korupolu, M.D.
General Practice
NPI 1861437428
12204 CORTEZ BLVD
Brooksville, FL 34613
(352) 799-3449
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Ridge Manor Family Clinic Inc's NPI number?

The NPI number for Ridge Manor Family Clinic Inc is 1730577115. It was assigned to this organization in the NPPES registry on January 7, 2015.

Where is Ridge Manor Family Clinic Inc located?

Ridge Manor Family Clinic Inc is located at 12204 Cortez Blvd, Brooksville, FL 34613. The listed phone number is (352) 799-3449.

What is Ridge Manor Family Clinic Inc's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Ridge Manor Family Clinic Inc enrolled in Medicare?

Yes. Ridge Manor Family Clinic Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ridge Manor Family Clinic Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Practice) reassigns their Medicare billing to Ridge Manor Family Clinic Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Ridge Manor Family Clinic Inc was last updated on February 10, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.