Individual provider Active NPI

Piya Suryadevara, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • South Miami, FL
National Provider Identifier
1033405329
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
ME130093 Issued in FL
Practice address
6200 SW 73Rd St
South Miami, FL 33143
Phone
(786) 662-4000
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X LA.207015 LA
Geriatric Medicine (Family Medicine) Physician 207QG0300X 61511 MN
Geriatric Medicine (Family Medicine) Physician 207QG0300X ME130093 FL Primary

Addresses

Primary practice location

6200 SW 73Rd St
South Miami, FL 33143

Mailing address

6200 SW 73Rd St
South Miami, FL 33143-4679
Phone (786) 662-4000

Other practice location 1

1406 6th Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

Other names 1

  • Piya Bhowmick Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20201029000845 NJ Practitioner - Family Practice 7517104300 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Emergency Medicine Associates, LLCGroup PAC ID 0941612840, 826 clinicians

Practice addresses (Care Compare)

94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone (973) 322-5000

Hospital & facility affiliations

  • Martin and Edith Stein Hospice, the Hospice, Somerset, NJ, CCN 311560
  • Dove Hospice Services of New Jersey, LLC Hospice, Manalapan, NJ, CCN 311590
  • Grace Healthcare Services LLC Hospice, Edison, NJ, CCN 311563
  • Bridgeway Care and Rehab Center at Bridgewater Nursing home, Bridgewater, NJ, CCN 315182
  • Foothill Acres Rehabilitation & Nursing Center Nursing home, Hillsborough, NJ, CCN 315425

Merit-based Incentive Payment System (MIPS)

Final score
87.07 of 100Reported as group
Quality
76.5
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LA.207015LAMDGeriatric Medicine (Family Medicine) Physician
61511MNMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Emergency Medicine Associates, LLC CurrentSince Nov 30, 2020 Accepting new patients

Locations

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

Interoperability endpoints

  • Direct secure messaging: psuryadevara45760@epicdirect.rwjbh.org

Organizations & group practices 2

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

Hospital & facility affiliations 5

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": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1033405329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 SW 73RD ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434679",
            "telephone_number": "786-662-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 SW 73RD ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "33143",
            "telephone_number": "786-662-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1406 6th Ave N",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563031900",
            "country_code": "US",
            "telephone_number": "320-251-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURYADEVARA",
        "first_name": "PIYA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "LA",
            "license": "LA.207015",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MN",
            "license": "61511",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME130093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PIYA",
            "last_name": "BHOWMICK",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.