Organization Active NPI

Sunrise Neurology PA

  • Neurology Physician
  • Zephyrhills, FL
National Provider Identifier
1063478279
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME86194 Issued in FL
Legal business name
SUNRISE NEUROLOGY PA
Practice address
38156 Medical Center Ave
Zephyrhills, FL 33540-1380
Phone
(813) 783-9799
Fax
(813) 783-9793
NPI assigned
Apr 25, 2006
Last updated
Jun 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Authorized official

Name
Prakashkumar Patel, MDNPI 1629079801
Title
Owner
Phone
(813) 783-9799

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME86194 FL Primary

Addresses

Primary practice location

38156 Medical Center Ave
Zephyrhills, FL 33540-1380

Mailing address

38156 Medical Center Ave
Zephyrhills, FL 33540-1380
Phone (813) 783-9799

Other identifiers 1

IdentifierTypeStateIssuer
267730000MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071001000221 FL Part B Supplier - Clinic/Group Practice 0042305443 Receives reassigned benefits from 1 practitioner
Practice locations: Wesley Chapel, FL; Zephyrhills, FL

National Provider Directory

National Provider Directory

Locations

2754 Windguard Cir
Ste 102
Wesley Chapel, FL 33544
Phone (813) 783-9799

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1063478279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38156 MEDICAL CENTER AVE",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335401380",
            "telephone_number": "813-783-9799",
            "fax_number": "813-783-9793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38156 MEDICAL CENTER AVE",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335401380",
            "telephone_number": "813-783-9799",
            "fax_number": "813-783-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE NEUROLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PRAKASHKUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-783-9799",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME86194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267730000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.