GAUTAM KANAKAMEDALA DO
NPI 1912600438
Student in an Organized Health Care Education/Training Program in Gainesville, FL

Active since March 23, 2023PECOS Enrolled
6500 W NEWBERRY RD, GAINESVILLE, FL 32605(352) 333-5982 Get Directions Write a Review

NPPES record last updated: March 23, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Gautam Kanakamedala Do NPPES

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

GAUTAM KANAKAMEDALA DO (NPI 1912600438) is an individual student in an organized health care education/training program in Gainesville, Florida and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912600438
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameGAUTAM KANAKAMEDALACredential: DO
Location Address6500 W NEWBERRY RDGainesville, FL 32605-4309
Mailing Address1147 Nw 64th TerGainesville, FL 32605-4218 · (352) 333-5982
Sole ProprietorNo
Enumeration DateMarch 23, 2023
NPPES CertifiedMarch 23, 2023
NPI 1912600438 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

6500 W NEWBERRY RD, Gainesville, FL 32605

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Gautam Kanakamedala Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 20

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

Internal Medicine
6500 W NEWBERRY RD
GAINESVILLE, FL 32605
Emergency Medicine
6500 W NEWBERRY RD
GAINESVILLE, FL 32605
Nurse Practitioner
6500 W NEWBERRY RD
GAINESVILLE, FL 32605
Emergency Medicine
6500 W NEWBERRY RD
GAINESVILLE, FL 32605
Emergency Medicine
6500 W NEWBERRY RD
GAINESVILLE, FL 32605
Physician Assistant
6500 W NEWBERRY RD
GAINESVILLE, FL 32605
Emergency Medicine
6500 W NEWBERRY RD
GAINESVILLE, FL 32605
Hospitalist
6500 W NEWBERRY RD
GAINESVILLE, FL 32605

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1912600438, enumerated as an "individual" on March 23, 2023.

The provider is located at 6500 W NEWBERRY RD GAINESVILLE, FL 32605 and the phone number is (352) 333-5982.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.