Individual provider Active NPI

Vasudevan Anjore Kidambi, M.D.

  • Family Medicine Physician
  • Ocala, FL
National Provider Identifier
1093799298
Registry record updated Oct 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0068971 Issued in FL
Practice address
3200 SW 34TH Ave
Suite 302
Ocala, FL 34474-7456
Phone
(352) 732-2900
Fax
(352) 732-4430
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0068971 FL Primary

Addresses

Primary practice location

3200 SW 34TH Ave
Suite 302
Ocala, FL 34474-7456

Mailing address

3200 SW 34TH Ave
Suite 302
Ocala, FL 34474-7456
Phone (352) 732-2900

Other identifiers 1

IdentifierTypeStateIssuer
379283800MedicaidFL

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
I20110805000194 FL Practitioner - Family Practice 9830368992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3200 SW 34 Ave
Suite 302
Ocala, FL 34474-7463

Hospital & facility affiliations

  • Marion Communtiy Hospital Hospital, Ocala, FL, CCN 100212
  • HCA Florida Ocala Hospital Inpatient rehabilitation facility, Ocala, FL, CCN 10T212

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0068971FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vasudevan Kidambi, MD, PA Family Medicine CurrentSince Jun 8, 2011 Accepting new patients

Locations

3200 SW 34th Ave
Ste 302
Ocala, FL 34474
Phone (352) 732-2900

Interoperability endpoints

  • Direct secure messaging: vkidambi@vkmp-fl.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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 2

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224460800000",
    "number": "1093799298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SW 34TH AVE",
            "address_2": "SUITE 302",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344747456",
            "telephone_number": "352-732-2900",
            "fax_number": "352-732-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SW 34TH AVE",
            "address_2": "SUITE 302",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344747456",
            "telephone_number": "352-732-2900",
            "fax_number": "352-732-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDAMBI",
        "first_name": "VASUDEVAN",
        "middle_name": "ANJORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2008-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0068971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379283800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.