Individual provider Active NPI

Keyur Anilkumar Chavda, M.D.

  • Surgery Physician
  • Brandon, FL
National Provider Identifier
1124218128
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME109259 Issued in FL
Practice address
116 Parsons Park Dr
Brandon, FL 33511-6066
Phone
(813) 684-5255
NPI assigned
Jul 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT186813 PA
Surgery Physician 208600000X ME109259 FL Primary

Addresses

Primary practice location

116 Parsons Park Dr
Brandon, FL 33511-6066

Mailing address

116 Parsons Park Dr
Brandon, FL 33511-6066
Phone (813) 684-5255

Other practice location 1

205 S Moon Ave Ste 102
Surgical Associates of Tampa Bay
Brandon, FL 33511-5716
Phone (813) 654-9557

Other identifiers 1

IdentifierTypeStateIssuer
003631400MedicaidFL

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
I20110629000426 FL Practitioner - General Surgery 8820276454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians
Hyperbaric and Woundcare IncGroup PAC ID 1052311560, 26 clinicians

Practice addresses (Care Compare)

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260

205 S Moon Ave
Brandon, FL 33511-5716
Phone (813) 615-7100

Hospital & facility affiliations

  • AdventHealth Carrollwood Hospital, Tampa, FL, CCN 100069
  • Adventhealth Riverview Hospital, Riverview, FL, CCN 100364
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT186813PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Palanisamy Rathinasamy MD PA CurrentSince Oct 1, 2012 Accepting new patients
Florida Hospital Physician Group Inc Surgery CurrentSince Mar 11, 2024 Accepting new patients

Locations

205 S Moon Ave
Ste 102
Brandon, FL 33511
Phone (813) 654-9557

116 Parsons Park Dr
Brandon, FL 33511
Phone (813) 681-6625

13149 Elk Mountain Dr
Riverview, FL 33579
Phone (813) 675-8326

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: kchavda625242@adventhealth.direct-ci.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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 6

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": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1124218128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 PARSONS PARK DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116066",
            "telephone_number": "813-684-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 PARSONS PARK DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116066",
            "telephone_number": "813-684-5255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 S Moon Ave Ste 102",
            "address_2": "Surgical Associates of Tampa Bay",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115716",
            "country_code": "US",
            "telephone_number": "813-654-9557",
            "fax_number": "813-654-4486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAVDA",
        "first_name": "KEYUR",
        "middle_name": "ANILKUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT186813",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME109259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003631400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.