Venkata R Pothuraju, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME103700 Issued in FL

Practice address

4930 E Lake Mary Blvd
Sanford, FL 32771-5003

Phone

(407) 322-8645

Fax

(407) 330-5074

NPI assigned

Mar 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Carespot of Orlando Hsi Urgent Care LLC

  • Urgent Care Clinic/Center
  • Orlando, FL
  • NPI 1306367503

  Family Medicine

  Medicare reassignment NPD
• Hma/Solantic Joint Venture, LLC

  • Urgent Care Clinic/Center
  • Vero Beach, FL
  • NPI 1689812109
  Medicare reassignment NPD
• Shands/Solantic Joint Venture, LLC

  • Urgent Care Clinic/Center
  • Gainesville, FL
  • NPI 1558595223
  Medicare reassignment NPD
• Solantic of Jacksonville, LLC

  • Urgent Care Clinic/Center
  • Ponte Vedra, FL
  • NPI 1407893100

  Family Medicine

  Medicare reassignment NPD
• Solantic/South Florida, LLC

  • Urgent Care Clinic/Center
  • Coral Springs, FL
  • NPI 1851344378
  Medicare reassignment NPD
• Central Florida Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Orlando, FL
  • NPI 1649241704
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1194843763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 E LAKE MARY BLVD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327715003",
            "telephone_number": "407-322-8645",
            "fax_number": "407-330-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 E LAKE MARY BLVD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327715003",
            "telephone_number": "407-322-8645",
            "fax_number": "407-330-5074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTHURAJU",
        "first_name": "VENKATA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME103700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000998900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Podiatric Medical Specialists of Florida
• Aleesa Junel Ponce, APRN, CNM
• Anita Louise Poole
• Pop Behavioral Services
• Viola Posley, PHD, LCSW, MSW
• Tekoa Pouerie
• Kalind Pradhan, MS
• Stephanie Pratt, PTA
• Premier Rehabilitation PLLC
• Premise Health of Florida Medical PA

• Family Medicine Physician in Sanford, FL
• Providers in Sanford, 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 Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.