NPIMap

Individual provider Active NPI

Lakshmi Kollu

  • Internal Medicine Physician
  • The Villages, FL
National Provider Identifier
1124478292
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME140018 Issued in FL
Practice address
1580 Santa Barbara Blvd
The Villages, FL 32159-6827
Phone
(352) 259-2159
Fax
(352) 259-5731
NPI assigned
Jun 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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 4301109900 MI
Internal Medicine Physician 207R00000X ME140018 FL Primary

Addresses

Primary practice location

1580 Santa Barbara Blvd
The Villages, FL 32159-6827

Mailing address

1580 Santa Barbara Blvd
The Villages, FL 32159-6827
Phone (352) 259-2159

Other practice location 1

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-4976

Other identifiers 2

IdentifierTypeStateIssuer
LK622OtherFLMEDICARE
103576600MedicaidFL

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
I20190801000302 FL Practitioner - Internal Medicine 2466744586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Internal Medicine PAGroup PAC ID 8022912914, 44 clinicians

Practice addresses (Care Compare)

6500 W Newberry Rd
Gainesville, FL 32605-4309
Phone (352) 384-3900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.42 of 100Reported as group
Quality
80.29
Improvement activities
40
Cost
75.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Internal Medicine PA CurrentSince Mar 1, 2021 Accepting new patients

Locations

6500 W Newberry Rd
Gainesville, FL 32605
Phone (352) 333-4180

Organizations & group practices 1

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 11

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": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1124478292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SANTA BARBARA BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596827",
            "telephone_number": "352-259-2159",
            "fax_number": "352-259-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 SANTA BARBARA BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596827",
            "telephone_number": "352-259-2159",
            "fax_number": "352-259-5731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 S Ballenger Hwy",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485323638",
            "country_code": "US",
            "telephone_number": "810-342-4976",
            "fax_number": "810-342-1591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLLU",
        "first_name": "LAKSHMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301109900",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME140018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "LK622",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103576600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.