Organization Active NPI

Naples Concierge Cardiology and Internal Medicine, LLC

  • Cardiovascular Disease Physician
  • Naples, FL
National Provider Identifier
1063086601
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
NAPLES CONCIERGE CARDIOLOGY AND INTERNAL MEDICINE, LLC
Practice address
625 9TH St N, Suite 104
Naples, FL 34102-8143
Phone
(239) 963-9788
Fax
(239) 963-9771
NPI assigned
May 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Authorized official

Name
Dr. Sajan Rao, MDNPI 1851589162
Title
Owner
Phone
(239) 963-9788

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

625 9TH St N, Suite 104
Naples, FL 34102-8143

Mailing address

625 9TH St N, Suite 104
Naples, FL 34102-8143
Phone (239) 963-9788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210907001482 FL Part B Supplier - Clinic/Group Practice 4880090448 Receives reassigned benefits from 2 practitioners
Practice locations: Naples, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2235260Naples Concierge Cardiology and Internal Medicine625 9TH St North - Ste 104, Naples, FL 34102Certificate of waiverSep 7, 2027

National Provider Directory

National Provider Directory

Locations

625 9th St N
Ste 104
Naples, FL 34102
Phone (239) 963-9788

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23972/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690502400000",
    "number": "1063086601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 9TH ST N, SUITE 104",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341028143",
            "telephone_number": "239-963-9788",
            "fax_number": "239-963-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 9TH ST N, SUITE 104",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341028143",
            "telephone_number": "239-963-9788",
            "fax_number": "239-963-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAPLES CONCIERGE CARDIOLOGY AND INTERNAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-18",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "RAO",
        "authorized_official_first_name": "SAJAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-963-9788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.