NPIMap

Individual provider Active NPI

Mudanai Panneerselvam Sabapathy, MD

  • Internal Medicine Physician
  • Melbourne, FL
National Provider Identifier
1063498327
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME93554 Issued in FL
Practice address
3044 W New Haven Ave
Melbourne, FL 32904-3566
Phone
(321) 473-8613
Fax
(321) 914-0229
NPI assigned
Dec 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME93554 FL Primary

Addresses

Primary practice location

3044 W New Haven Ave
Melbourne, FL 32904-3566

Mailing address

PO Box 361095
Melbourne, FL 32936-1095
Phone (321) 473-8613

Other identifiers 6

IdentifierTypeStateIssuer
3956149OtherFLAETNA
7370660OtherFLAETNA
9699993002OtherFLCIGNA
16559OtherFLBLUE CROSS BLUE SHIELD
294728OtherFLWELLCARE
273009000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050818000713 FL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 0648200683 Reassigns benefits to 4 organizations
I20170927004086 MO Practitioner - Internal Medicine 0648200683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Brevard LLCGroup PAC ID 4486558012, 75 clinicians

Practice addresses (Care Compare)

3044 W New Haven Ave
West Melbourne, FL 32904-3566
Phone (321) 473-8613

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Brevard LLC CurrentSince Nov 1, 2019 Accepting new patients
Comprehensive Hospitalists of Florida, LLC CurrentSince Apr 24, 2018 Accepting new patients
Coral Springs Physician Services, LLC CurrentSince Jun 1, 2017 Accepting new patients
Fort Lauderdale Physician Services, LLC CurrentSince Jun 28, 2017 Accepting new patients
Butler Physician Services, LLC Internal Medicine CurrentSince Aug 29, 2017 Accepting new patients
Healing Tree Internal Medicine LLC Internal Medicine Past Accepting new patients

Locations

6401 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 776-8500

1305 Hickory St
Melbourne, FL 32901
Phone (321) 255-1500

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

3044 W New Haven Ave
West Melbourne, FL 32904
Phone (321) 473-8613

3100 Oak Grove Rd
Rombauer, MO 63901
Phone (573) 776-2000

Interoperability endpoints

  • Direct secure messaging: msabapathy71806@epicdirect.hf.org
  • Direct secure messaging: mudanaisabapathy@mab.medentdirect.com

Organizations & group practices 6

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 8

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1063498327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361095",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329361095",
            "telephone_number": "321-473-8613",
            "fax_number": "321-914-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3044 W NEW HAVEN AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329043566",
            "telephone_number": "321-473-8613",
            "fax_number": "321-914-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABAPATHY",
        "first_name": "MUDANAI",
        "middle_name": "PANNEERSELVAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME93554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3956149",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7370660",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9699993002",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "16559",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "294728",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273009000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.