NPIMap

Individual provider Active NPI

Sanjiva Michael Lutchmedial, MD.

  • Pulmonary Disease Physician
  • Clearwater, FL
National Provider Identifier
1033379649
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME133652 Issued in FL
Practice address
430 Morton Plant St Ste 405
Clearwater, FL 33756
Phone
(727) 443-0611
Fax
(727) 461-5493
NPI assigned
Jun 17, 2008
Last updated
Apr 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 0101254085 VA
Pulmonary Disease Physician 207RP1001X ME133652 FL Primary

Addresses

Primary practice location

430 Morton Plant St Ste 405
Clearwater, FL 33756

Mailing address

2900 Lamb Circle, Suite 7-700B.
Carilion New River Valley (CMRV)
Christiansburg, VA 24073
Phone (540) 731-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180711002110 FL Practitioner - Pulmonary Disease 6204051451 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians
Bay Area Chest Physicians P aGroup PAC ID 0941299010, 15 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

300 Pinellas St
Clearwater, FL 33756-3804
Phone (727) 461-8231

3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607
Phone (727) 725-6526

430 Morton Plant St
Suite 405
Clearwater, FL 33756-3394
Phone (727) 443-0611

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101254085VAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Bay Area Chest Physicians P a Pulmonary Disease CurrentSince Jul 1, 2018 Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

430 Morton Plant St
Ste 405
Clearwater, FL 33756
Phone (727) 443-0611

616 E St
Clearwater, FL 33756
Phone (727) 443-0611

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEFFBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/HEFFBA/Endpoint/HEFFBA
  • Direct secure messaging: sanjiva.lutchmedial@bacp.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1033379649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 LAMB CIRCLE, SUITE 7-700B.",
            "address_2": "CARILION NEW RIVER VALLEY (CMRV)",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "24073",
            "telephone_number": "540-731-2000",
            "fax_number": "540-983-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MORTON PLANT ST STE 405",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33756",
            "telephone_number": "727-443-0611",
            "fax_number": "727-461-5493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTCHMEDIAL",
        "first_name": "SANJIVA",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101254085",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME133652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.