Individual provider Active NPI

Dipak Kumar Mukherjee, MD

  • Cardiovascular Disease Physician
  • St Petersburg, FL
National Provider Identifier
1124057476
Registry record updated Apr 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME0027748 Issued in FL
Practice address
5880 49TH St N
Suite 203N
St Petersburg, FL 33709-2150
Phone
(727) 527-6464
Fax
(727) 526-6296
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME0027748 FL Primary

Addresses

Primary practice location

5880 49TH St N
Suite 203N
St Petersburg, FL 33709-2150

Mailing address

5880 49TH St N
Suite 203N
St Petersburg, FL 33709-2150
Phone (727) 527-6464

Other identifiers 2

IdentifierTypeStateIssuer
406111598OtherRAILROAD MEDICARE PIN
058501700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0027748FLMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272412800000",
    "number": "1124057476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 49TH ST N",
            "address_2": "SUITE 203N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092150",
            "telephone_number": "727-527-6464",
            "fax_number": "727-526-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 49TH ST N",
            "address_2": "SUITE 203N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092150",
            "telephone_number": "727-527-6464",
            "fax_number": "727-526-6296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKHERJEE",
        "first_name": "DIPAK",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2010-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME0027748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "406111598",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058501700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.