Suresh C Mishra Mdpa

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME 54969 Issued in FL

Legal business name

SURESH C MISHRA MDPA

Practice address

3332 17TH St
Sarasota, FL 34235-8904

Phone

(941) 365-2171

Fax

(941) 957-3349

NPI assigned

Oct 28, 2010

Organization subpart

No

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

Authorized official

Name

Suresh C Mishra, MDNPI 1720011687

Title

President

Phone

(941) 365-2171

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suresh C Mishra, M.D.

  • Family Medicine Physician
  • Sarasota, FL
  • NPI 1720011687
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1194025791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3332 17TH ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342358904",
            "telephone_number": "941-365-2171",
            "fax_number": "941-957-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3332 17TH ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342358904",
            "telephone_number": "941-365-2171",
            "fax_number": "941-957-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURESH C MISHRA MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-28",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "MISHRA",
        "authorized_official_first_name": "SURESH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-365-2171",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 54969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.