Individual provider Active NPI

Siva S. Gummadi, M.D.

  • Interventional Cardiology Physician
  • Ocala, FL
National Provider Identifier
1063448488
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME72590 Issued in FL
Practice address
2105 SW 20TH PL
Ocala, FL 34471-7734
Phone
(352) 622-4251
Fax
(352) 622-0102
NPI assigned
Jun 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME72590 FL
Interventional Cardiology Physician 207RI0011X ME72590 FL Primary

Addresses

Primary practice location

2105 SW 20TH PL
Ocala, FL 34471-7734

Mailing address

2111 SW 20TH PL
Ocala, FL 34471-7734
Phone (352) 622-4251

Other identifiers 3

IdentifierTypeStateIssuer
253395200MedicaidFL
P00209067OtherFLRAILROAD MEDICARE
45041OtherFLBCBS

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
I20031125000316 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Nuclear MedicinePractitioner - Peripheral Vascular Disease 6305740986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine, Nuclear Medicine, Peripheral Vascular Disease
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Institute of Central Florida LLCGroup PAC ID 2769587146, 67 clinicians

Practice addresses (Care Compare)

2105 SW 20TH PL
Ocala, FL 34471-7734
Phone (352) 622-4251

Hospital & facility affiliations

  • Adventhealth Ocala Hospital, Ocala, FL, CCN 100062
  • Marion Communtiy Hospital Hospital, Ocala, FL, CCN 100212

Merit-based Incentive Payment System (MIPS)

Final score
98.21 of 100Reported as individual
Promoting interoperability
96
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal29
Leg revascularization (restoring blood flow)62

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Institute of Central Florida, LLC CurrentSince Feb 11, 2009 Accepting new patients
Cvi Ambulatory Surgery Center LLC Current Accepting new patients
Cardiovascular Institute of Central Florida, LLC Cardiovascular Disease CurrentSince Feb 11, 2009 Accepting new patients
Ocala Health Primary Care LLC Past Accepting new patients

Locations

121 Lagrande Blvd
Ste A
Lady Lake, FL 32159
Phone (352) 351-1555

121 Lagrande Blvd
Lady Lake, FL 32159
Phone (352) 259-5960

13940 N US Highway 441
Ste 102
Lady Lake, FL 32159
Phone (352) 509-9900

2111 SW 20th Pl
Ocala, FL 34471
Phone (352) 547-3399

3310 SW 34th St
Ocala, FL 34474
Phone (352) 237-4004

6547 SW State Road 200
Ocala, FL 34476
Phone (352) 355-3300

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: siva.gummadi.1@29679.direct.athenahealth.com

Organizations & group practices 4

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 2

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1063448488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 SW 20TH PL",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344717734",
            "telephone_number": "352-622-4251",
            "fax_number": "352-622-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 SW 20TH PL",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344717734",
            "telephone_number": "352-622-4251",
            "fax_number": "352-622-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMMADI",
        "first_name": "SIVA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME72590",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME72590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253395200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00209067",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "45041",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.