Individual provider Active NPI

Kavita Bakthavatsalam Rao, M.D.

  • Internal Medicine Physician
  • Saint Petersburg, FL
National Provider Identifier
1083684153
Registry record updated Jan 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME89679 Issued in FL
Practice address
4957 38TH Avenue North
Suite C
Saint Petersburg, FL 33710-2174
Phone
(727) 525-0900
Fax
(727) 525-9500
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301072100 MI
Internal Medicine Physician 207R00000X ME89679 FL Primary

Addresses

Primary practice location

4957 38TH Avenue North
Suite C
Saint Petersburg, FL 33710-2174

Mailing address

4957 38TH Avenue North
Suite C
Saint Petersburg, FL 33710-2174
Phone (727) 525-0900

Other identifiers 2

IdentifierTypeStateIssuer
277550600MedicaidFL
4596992-10MedicaidMI

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
I20070418000231 FL Practitioner - Internal Medicine 5890778211 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Hospitalists of PinellaGroup PAC ID 0648267609, 24 clinicians
H2 Rehabilitation Services of Florida LLCGroup PAC ID 3971411851, shared by 10 NPIs, 257 clinicians

Practice addresses (Care Compare)

1173 Turner St
Clearwater, FL 33756-4135
Phone 7272988496210

4957 38TH Ave N
Suite C
St Petersburg, FL 33710-2174
Phone (727) 525-0900

6280 Central Ave
St Petersburg, FL 33707-1429
Phone (800) 699-9395

Hospital & facility affiliations

  • HCA Florida Largo Hospital Hospital, Largo, FL, CCN 100248
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • St Anthonys Hospital Hospital, Saint Petersburg, FL, CCN 100067
  • HCA Florida St Petersburg Hospital Hospital, Saint Petersburg, FL, CCN 100180

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME89679FLMDInternal Medicine Physician
4301072100MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospitalists of Pinella CurrentSince Jan 1, 2016 Accepting new patients
Gulf Coast Internist, LLC. Internal Medicine CurrentSince Sep 25, 2009 Accepting new patients
Sunstate Physicians LLC Internal Medicine CurrentSince Feb 15, 2023 Accepting new patients
Elias Kanaan MD PA Internal Medicine PastSince Aug 20, 2001 Accepting new patients
Promed Ipa LLC Internal Medicine Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients
Oakwood Healthcare Inc Past Accepting new patients

Locations

2234 N Federal Hwy
Boca Raton, FL 33431
Phone (561) 306-5469

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

1173 Turner St
Clearwater, FL 33756
Phone (727) 298-8496

801 West Bay Dr
Ste 321
Largo, FL 33770
Phone (561) 302-6086

4957 38th Ave N
Ste C
St Petersburg, FL 33710
Phone (727) 521-4402

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HHIJBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/ADDJAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/HHIJBA/Endpoint/HHIJBA
  • Direct secure messaging: kavita.rao@gcillc.eclinicaldirectplus.com

Organizations & group practices 7

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 6

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390176000000",
    "number": "1083684153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4957 38TH AVENUE NORTH",
            "address_2": "SUITE C",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337102174",
            "telephone_number": "727-525-0900",
            "fax_number": "727-525-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4957 38TH AVENUE NORTH",
            "address_2": "SUITE C",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337102174",
            "telephone_number": "727-525-0900",
            "fax_number": "727-525-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "KAVITA",
        "middle_name": "BAKTHAVATSALAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2014-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301072100",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME89679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277550600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4596992-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

Verify at the official NPI Registry.