NPIMap

Individual provider Active NPI

Shravan Ambati, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Orlando, FL
National Provider Identifier
1104985290
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
ME105350 Issued in FL
Practice address
11616 Lake Underhill Rd Ste 215
Orlando, FL 32825-4465
Phone
(407) 482-7788
Fax
(407) 482-8698
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X ME105350 FL Primary

Addresses

Primary practice location

11616 Lake Underhill Rd Ste 215
Orlando, FL 32825-4465

Mailing address

11616 Lake Underhill Rd Ste 215
Orlando, FL 32825-4465
Phone (407) 482-7788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100617000300 FL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2961416888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Heart and Vascular Center LLC 7 clinicians
Gulf Coast Multispeciality Services, LLC 19 clinicians

Practice addresses (Care Compare)

11616 Lake Underhill Rd
Suite 215
Orlando, FL 32825-4465
Phone (407) 482-7788

2202 State Ave
Suite 207
Panama City, FL 32405-4582
Phone (850) 780-2141

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Oviedo Medical Center Hospital, Oviedo, FL, CCN 100329
  • Orlando Health Hospital, Orlando, FL, CCN 100006

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME105350FLMDSpecialist

Practice roles (8 of 10)

OrganizationSpecialtyStatusNew patients
Orlando Heart & Vascular Center LLC Clinical Cardiac Electrophysiology CurrentSince Dec 23, 2012 Accepting new patients
Gulf Coast Multispeciality Services, LLC CurrentSince Jun 24, 2024 Accepting new patients
Inpatient Consultants of Florida, Inc Past Accepting new patients
Miramar Ekg Readers Past Accepting new patients
Cardiovascular Associates of the Delaware Valley,P a PastSince Sep 1, 2023 Accepting new patients
Memorial Ekg Associates PA Past Accepting new patients
Tradewinds Park Inpatient Services, LLC Past Accepting new patients
Ekg Associates Inc Past Accepting new patients

Locations

1786 N Mills Ave
Orlando, FL 32803
Phone (407) 985-2880

1780 N Mills Ave
Orlando, FL 32803
Phone (407) 426-8484

11616 Lake Underhill Rd
Ste 215
Orlando, FL 32825
Phone (407) 601-5308

2202 State Ave
Ste 207
Panama City, FL 32405
Phone (850) 784-1856

2202 State Ave
Ste 303
Panama City, FL 32405
Phone (850) 784-1856

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 8

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 4

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1104985290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11616 LAKE UNDERHILL RD STE 215",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254465",
            "telephone_number": "407-482-7788",
            "fax_number": "407-482-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11616 LAKE UNDERHILL RD STE 215",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254465",
            "telephone_number": "407-482-7788",
            "fax_number": "407-482-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBATI",
        "first_name": "SHRAVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "FL",
            "license": "ME105350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.