Active NPI
Praveen Kumar Rohatgi, MD
- Cardiovascular Disease Physician
- Tampa, FL
National Provider Identifier
1093701773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- ME47652
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0448401 | Medicaid | FL |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| ME47652 | FL | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New 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
- prohatgi8148@direct.tgh.org
- praveen.rohatgi.1@18455.direct.athenahealth.com
- 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.
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
-
- Audiologist
- Lakeland, FL
- NPI 1083931471
-
- Cardiovascular Disease Physician
- Tampa, FL
- NPI 1104815661
-
- Allergy & Immunology Physician
- Tampa, FL
- NPI 1225329261
-
- Diagnostic Radiology Physician
- Tampa, FL
- NPI 1467654244
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.