Individual provider Active NPI

Samantha Kalakurthy, MD

  • Nephrology Physician
  • Sarasota, FL
National Provider Identifier
1124227319
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME133567 Issued in FL
Practice address
1921 Waldemere St Ste 306
Sarasota, FL 34239
Phone
(913) 283-8063
Fax
(913) 238-8854
NPI assigned
Jul 17, 2007
Last updated
Aug 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 0433257 KS
Hospitalist Physician 208M00000X D0069457 MD
Hospitalist Physician 208M00000X 0101256679 VA
Student in an Organized Health Care Education/Training Program 390200000X
Nephrology Physician 207RN0300X ME133567 FL Primary

Addresses

Primary practice location

1921 Waldemere St Ste 306
Sarasota, FL 34239

Mailing address

1921 Waldemere St Ste 306
Sarasota, FL 34239-2941
Phone (941) 917-8722

Other identifiers 1

IdentifierTypeStateIssuer
023392600MedicaidFL

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
I20171227000319 FL Practitioner - Nephrology 7113081738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

1921 Waldemere St
Suite 306
Sarasota, FL 34239-2941
Phone (941) 917-8722

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.55 of 100Reported as individual
Quality
77.37
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0069457MDMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney Physicians , LLC Nephrology CurrentSince May 1, 2022 Accepting new patients
Florida Kidney Physicians, LLC Nephrology CurrentSince May 1, 2022 Accepting new patients

Locations

1150 N 35th Ave
Ste 620
Hollywood, FL 33021
Phone (954) 612-8173

19056 NE 29th Ave
Miami, FL 33180
Phone (305) 354-4558

929 S Tamiami Trl
Ste 203
Osprey, FL 34229
Phone (941) 917-7197

1921 Waldemere St
Ste 306
Sarasota, FL 34239
Phone (941) 917-8722

5350 University Pkwy
Ste 207
Sarasota, FL 34243
Phone (941) 917-4250

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4
  • Direct secure messaging: samantha.kalakurthy.1@15644.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1124227319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 WALDEMERE ST STE 306",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392941",
            "telephone_number": "941-917-8722",
            "fax_number": "941-917-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 WALDEMERE ST STE 306",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34239",
            "telephone_number": "913-283-8063",
            "fax_number": "913-238-8854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALAKURTHY",
        "first_name": "SAMANTHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "KS",
            "license": "0433257",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MD",
            "license": "D0069457",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101256679",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME133567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023392600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.