Individual provider Active NPI

Sumanth Padmanabh, MD

  • Internal Medicine Physician
  • The Villages, FL
National Provider Identifier
1104144419
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 124652 Issued in FL
Practice address
1950 Laurel Manor Dr
Building 200, Suite 206
The Villages, FL 32162-5603
Phone
(352) 205-8812
NPI assigned
May 11, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 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 8153512-1205 UT
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME 124652 FL Primary

Addresses

Primary practice location

1950 Laurel Manor Dr
Building 200, Suite 206
The Villages, FL 32162-5603

Mailing address

PO Box 1493
Tavares, FL 32778-1493

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
I20160202000033 FL Practitioner - Internal Medicine 9638319536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arbor Medical Group, PLLC 2 clinicians

Practice addresses (Care Compare)

1950 Laurel Manor Dr
Suite 206
The Villages, FL 32162-5608
Phone (352) 205-8812

Hospital & facility affiliations

  • Villages Regional Hospital, the Hospital, The Villages, FL, CCN 100290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 124652FLMDInternal Medicine Physician
8153512-1205UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arbor Medical Group, PLLC Internal Medicine CurrentSince Nov 15, 2015 Accepting new patients

Locations

1950 Laurel Manor Dr
Bldg 200
The Villages, FL 32162
Phone (352) 205-8812

1950 Laurel Manor Dr
Ste 200
The Villages, FL 32162
Phone (352) 742-2286

1950 Laurel Manor Dr
Ste 206
The Villages, FL 32162
Phone (352) 205-8812

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 1

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": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1104144419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1493",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327781493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 LAUREL MANOR DR",
            "address_2": "BUILDING 200, SUITE 206",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625603",
            "telephone_number": "352-205-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADMANABH",
        "first_name": "SUMANTH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-11",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "8153512-1205",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 124652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.