NPIMap

Organization Active NPI

Cardiac and Vascular Consultants MD PA

  • Medical Specialty Clinic/Center
  • The Villages, FL
National Provider Identifier
1093006108
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
CARDIAC AND VASCULAR CONSULTANTS MD PA
Practice address
1050 Old Camp Rd
Suite 270
The Villages, FL 32162-1762
Phone
(352) 552-4648
NPI assigned
Apr 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Authorized official

Name
Shrikanth P Upadya, MDNPI 1750492195
Title
President
Phone
(352) 552-4648

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
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

1050 Old Camp Rd
Suite 270
The Villages, FL 32162-1762

Mailing address

1050 Old Camp Rd
Suite 270
The Villages, FL 32162-1762
Phone (352) 633-1966

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110606000489 FL Part B Supplier - Clinic/Group Practice 0345427019 Receives reassigned benefits from 19 practitioners
Practice locations: Lady Lake, FL; Wildwood, FL; The Villages, FL; Tavares, FL; Summerfield, FL; Ocala, FL; Leesburg, FL; Lecanto, 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
10D2025484Cardiac and Vascular Consultants Inc1050 Old Camp Rd Ste 270, Lady Lake, FL 32162Certificate of waiverJun 8, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

4224 W Gulf To Lake Hwy
#44
Lecanto, FL 34461

17190 SE 109th Terrace Rd
Summerfield, FL 34491
Phone (352) 268-0003

1858 Mayo Dr
Tavares, FL 32778
Phone (352) 383-5200

340 Heald Way
The Villages, FL 32163
Phone (352) 330-1154

1050 Old Camp Rd
The Villages, FL 32162
Phone (352) 606-4708

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353024000000",
    "number": "1093006108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 OLD CAMP RD",
            "address_2": "SUITE 270",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321621762",
            "telephone_number": "352-633-1966",
            "fax_number": "352-633-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 OLD CAMP RD",
            "address_2": "SUITE 270",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321621762",
            "telephone_number": "352-552-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIAC AND VASCULAR CONSULTANTS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-22",
        "last_updated": "2012-11-16",
        "status": "A",
        "authorized_official_last_name": "UPADYA",
        "authorized_official_first_name": "SHRIKANTH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-552-4648",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; 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.