DR. PRAVEEN K GOOTAM (M.D.) – Psychiatry Physician, NPI 1417148610

DR. PRAVEEN K GOOTAM (M.D.) is a healthcare provider. based in Tampa, Florida. specializing in PSYCHIATRY, NEUROLOGY. They hold the professional credentials M.D.. They hold a License No. ME99352 (FL). The NPI Number for DR. PRAVEEN K GOOTAM (M.D.) is 1417148610

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
DR. PRAVEEN K GOOTAM (M.D.)
NPI
1417148610
Phone
(813) 972-2000
Address
13000 BRUCE B DOWNS BLVD
Enumeration Date
5 August 2007
Last Update Date
31 December 2019

Doctor Profile

Medical School Name
LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Secondary Phone
7275321355
Graduation Year
2005 (21 years ago)
PAC ID
9234398447
Group Practice PAC ID
2567624836
Professional Enrollment ID
I20120307000800
Address ID
FL346521971NE6600XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience70
Completeness75
Years active:18State licenses:1Digital endpointsOther names

1,954 PSYCHIATRY in FL

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Provider Addresses for DR. PRAVEEN K GOOTAM (M.D.)

  • James A. Haley Veterans' Hospital, 13000, Bruce B Downs Boulevard, Tampa, Hillsborough County, Florida, 33612, United States

    BLDG 38, RM C373

    TAMPA, FL 336124745

    Phone: (813) 972-2000

    Fax: (813) 341-8855

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-03-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120307000800IPsychiatryFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33612)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2567624836View full group profile
NameSpecialtyState
P S Y C H I A T R YFL
P S Y C H I A T R YFL
P S Y C H I A T R YFL
P S Y C H I A T R YPR
-FL
Clinical PsychologistFL
P S Y C H I A T R YFL
P S Y C H I A T R YFL
P S Y C H I A T R YFL
P S Y C H I A T R YFL

Reviews

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Frequently asked questions

Can I use this page to confirm DR. PRAVEEN K GOOTAM (M.D.)'s NPI?
Yes. DR. PRAVEEN K GOOTAM (M.D.) is listed with NPI 1417148610 in the public NPI dataset.
Does the file indicate DR. PRAVEEN K GOOTAM (M.D.) is practicing under active NPI?
Directory data currently reports DR. PRAVEEN K GOOTAM (M.D.) as active.
What is DR. PRAVEEN K GOOTAM (M.D.)'s primary classification?
Psychiatry Physician is the headline specialty for DR. PRAVEEN K GOOTAM (M.D.) here. Clinical services aligned with this taxonomy classification.
What area does DR. PRAVEEN K GOOTAM (M.D.) serve?
DR. PRAVEEN K GOOTAM (M.D.)'s listing highlights Tampa, Florida; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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