Active NPI
Premier Health Care Inc
- Internal Medicine Physician
- Saint Petersburg, FL
National Provider Identifier
1124119151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- PREMIER HEALTH CARE INC
- Practice address
- 218 Pasadena Ave S
Saint Petersburg, FL 33707-1251 - Phone
- (727) 345-0160
- NPI assigned
- Sep 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Vijaya L Cherukuri, M.D.
- Title
- Medical Director
- Phone
- (727) 345-0160
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
218 Pasadena Ave S
Saint Petersburg, FL 33707-1251
Mailing address
9823 Sago Point Dr
Largo, FL 33777-4905
Phone (727) 452-4949
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040909001121 | FL | Part B Supplier - Clinic/Group Practice | 4284600222 |
Receives reassigned benefits from 9 practitioners Practice locations: St Petersburg, FL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0984573 | Premier Health Care Inc | Certificate of waiver | Oct 4, 2026 |
National Provider Directory
National Provider DirectoryLocations
1609 Pasadena Ave S
Ste 2C
South Pasadena, FL 33707
Phone (727) 302-9000
218 Pasadena Ave S
St Petersburg, FL 33707
Phone (727) 345-0160
Practitioners & affiliated clinicians
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Internal Medicine) Physician
- Saint Petersburg, FL
- NPI 1750375267
FL
-
- Geriatric Medicine (Family Medicine) Physician
- Plant City, FL
- NPI 1841455607
FL
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1199232000000",
"number": "1124119151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9823 SAGO POINT DR",
"city": "LARGO",
"state": "FL",
"postal_code": "337774905",
"telephone_number": "727-452-4949",
"fax_number": "727-345-0100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 PASADENA AVE S",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337071251",
"telephone_number": "727-345-0160"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMIER HEALTH CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-27",
"last_updated": "2008-01-02",
"status": "A",
"authorized_official_last_name": "CHERUKURI",
"authorized_official_first_name": "VIJAYA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "727-345-0160",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.