Individual provider Active NPI

Santu Saha, M.D.

  • Internal Medicine Physician
  • Sebring, FL
National Provider Identifier
1174872162
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
56892 Issued in KY
Practice address
4200 Sun N Lake Blvd
Sebring, FL 33872-1986
Phone
(863) 402-3402
Fax
(863) 402-3111
NPI assigned
Sep 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME125397 FL
Internal Medicine Physician 207R00000X 56892 KY Primary

Addresses

Primary practice location

4200 Sun N Lake Blvd
Sebring, FL 33872-1986

Mailing address

4200 Sun N Lake Blvd
Sebring, FL 33872-1986
Phone (863) 402-3402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181022003357 GA Practitioner - Internal Medicine 4880815166 Reassigns benefits to 1 organization
I20220707003668 KY Practitioner - Internal Medicine 4880815166 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as group
Improvement activities
40
Cost
75.33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56892KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians, P.C. CurrentSince Aug 15, 2018 Accepting new patients
24 On Physicians, PC CurrentSince Aug 15, 2018 Accepting new patients
Green Valley Hospital Medicine Physicians, LLC Internal Medicine CurrentSince Oct 16, 2023 Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Dec 1, 2023 Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

2501 Kentucky Ave
Paducah, KY 42003
Phone (270) 575-2180

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1174872162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338721986",
            "telephone_number": "863-402-3402",
            "fax_number": "863-402-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338721986",
            "telephone_number": "863-402-3402",
            "fax_number": "863-402-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHA",
        "first_name": "SANTU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-05",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME125397",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "56892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.