Individual provider Active NPI

Bhavagan S Maganti, MD

  • Anesthesiology Physician
  • Auburn, ME
National Provider Identifier
1003818923
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME85406 Issued in FL
Practice address
690 Minot Ave Ste 1
Auburn, ME 04210-3922
Phone
(207) 344-2220
NPI assigned
Aug 11, 2005
Last updated
Dec 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME85406 FL Primary
Anesthesiology Physician 207L00000X 008618 ME

Addresses

Primary practice location

690 Minot Ave Ste 1
Auburn, ME 04210-3922

Mailing address

324 Gannett Dr Ste 200
South Portland, ME 04106-3266

Other identifiers 4

IdentifierTypeStateIssuer
297670099MedicaidME
300803700OtherFLDOL ACS (FECA) W/C
P00009748OtherFLMEDICARE RAILROAD
29222OtherFLFL BCBS PROVIDER #

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120612000366 FL Practitioner - Anesthesiology 0941289045 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
008618MEMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Anesthesia LLC CurrentSince Nov 1, 2022 Accepting new patients
Sheridan Healthcorp, Inc. Anesthesiology CurrentSince Jan 1, 2014 Accepting new patients
Sheridan Healthcorp Inc Anesthesiology Current Accepting new patients
Florida Gulf-to-Bay Anesthesiology Associates, LLC Anesthesiology Past Accepting new patients
Collier Anesthesia PA Anesthesiology Past Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

8787 Bryan Dairy Rd
Ste 300
Seminole, FL 33777
Phone (727) 394-5300

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1003818923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 GANNETT DR STE 200",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 MINOT AVE STE 1",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042103922",
            "telephone_number": "207-344-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGANTI",
        "first_name": "BHAVAGAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME85406",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ME",
            "license": "008618",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297670099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL ACS (FECA) W/C",
            "identifier": "300803700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00009748",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BCBS PROVIDER #",
            "identifier": "29222",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, ME

Sources for this page

Verify at the official NPI Registry.