Individual provider Active NPI

Praveen Kumar Rohatgi, MD

  • Cardiovascular Disease Physician
  • Tampa, FL
National Provider Identifier
1093701773
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME47652 Issued in FL
Practice address
2708 W Virginia Ave
Tampa, FL 33607-6380
Phone
(813) 875-7088
NPI assigned
Sep 27, 2005
Reactivated
Apr 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME47652 FL
Cardiovascular Disease Physician 207RC0000X ME47652 FL Primary
Interventional Cardiology Physician 207RI0011X ME47652 FL

Addresses

Primary practice location

2708 W Virginia Ave
Tampa, FL 33607-6380

Mailing address

PO Box 273512
Tampa, FL 33688-3512
Phone (813) 875-7088

Other identifiers 1

IdentifierTypeStateIssuer
0448401MedicaidFL

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
I20101115001235 FL Practitioner - Cardiovascular Disease (Cardiology) 0446445548 Practice locations: Tampa, FL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME47652FLMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Cornerstone Health Specialists Past Accepting new patients
Nalini Rohatgi MD PA Past Accepting new patients
Tower Imaging LLC Past Accepting new patients
Ekg Interpretations Cardiovascular Disease Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: prohatgi8148@direct.tgh.org
  • Direct secure messaging: praveen.rohatgi.1@18455.direct.athenahealth.com
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1093701773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 273512",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336883512",
            "telephone_number": "813-875-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 W VIRGINIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076380",
            "telephone_number": "813-875-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHATGI",
        "first_name": "PRAVEEN",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2016-05-20",
        "deactivation_date": "2006-03-24",
        "reactivation_date": "2006-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME47652",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME47652",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME47652",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0448401",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.