Siva Suryadevara, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

ME116319 Issued in FL

Practice address

205 Zeagler Dr Ste 101
Palatka, FL 32177-3860

Phone

(386) 325-2836

Fax

(386) 326-2736

NPI assigned

Jan 23, 2007

Last updated

Jan 26, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL, GA, WI3 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 3

Specialty

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCHS Hospitals IncGroup PAC ID 5698071173, shared by 28 NPIs, 1,195 clinicians

Upson Surgical Associates, LLCGroup PAC ID 2062690480, 18 clinicians

First Coast Cardiovascular Institute, LLCGroup PAC ID 6002803020, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Putnam Hospital Hospital, Palatka, FL, CCN 100232
• Upson Regional Medical Center Hospital, Thomaston, GA, CCN 110002
• Marshfield Medical Center - Weston Hospital, Weston, WI, CCN 520202

Merit-based Incentive Payment System (MIPS)

Final score

59.59 of 100Reported as apm

Quality

59.93

Promoting interoperability

0

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/67ff075a-8289-4f2d-a8eb-5dc1f0d954ab/
• FHIR API: https://fhir4.healow.com/fhir/r4/IEIHCA

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.

• First Coast Cardiovascular Institute, LLC

  • Cardiovascular Disease Physician
  • Jacksonville, FL
  • NPI 1841307857
  Medicare reassignment Care Compare group NPD
• Upson Surgical Associates, LLC

  • Surgery Physician
  • Thomaston, GA
  • NPI 1790076974
  Medicare reassignment Care Compare group NPD
• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452

  GA

  Medicare reassignment NPD
• Beaver Dam Community Hospitals Inc

  dba Marshfield Medical Center - Beaver Dam Professional Services

  • Clinic/Center
  • Beaver Dam, WI
  • NPI 1972188555
  Medicare reassignment NPD
• Flambeau Hospital Inc

  dba MMC - Park Falls Outreach Services

  • Clinic/Center
  • Park Falls, WI
  • NPI 1194317966
  Medicare reassignment NPD
• Flambeau Hospital Inc

  dba Marshfield Medical Center - Park Falls

  • Critical Access Hospital
  • Park Falls, WI
  • NPI 1700963048
  Medicare reassignment NPD
• Lakeview Medical Center Inc of Rice Lake

  dba Marshfield Medical Center - Rice Lake Professional Services

  • Clinic/Center
  • Rice Lake, WI
  • NPI 1093201832
  Medicare reassignment NPD
• Marshfield Clinic Inc

  dba Marshfield Clinic Florida Teleradiology/Telehealth

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434
  Medicare reassignment NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center - Ladysmith

  • Critical Access Hospital
  • Ladysmith, WI
  • NPI 1952890873
  Medicare reassignment NPD
• Memorial Hospital Inc

  dba Marshfield Medical Center - Neillsville

  • Critical Access Hospital
  • Neillsville, WI
  • NPI 1346239373
  Medicare reassignment NPD
• First Coast Cardiovascular Institute LLC

  • Cardiac Rehabilitation Clinic/Center
  • Jacksonville, FL
  • NPI 1013711498
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Putnam Community Medical Center of North Florida, LLC

  dba HCA Florida Putnam Hospital

  • General Acute Care Hospital
  • Palatka, FL
  • NPI 1487045100
  Care Compare affiliation
• MCHS Hospitals Inc

  dba Marshfield Medical Center - Weston

  • General Acute Care Hospital
  • Weston, WI
  • NPI 1902437650
  Care Compare affiliation
• Upson County Hospital Inc

  dba Upson Regional Medical Center

  • General Acute Care Hospital
  • Thomaston, GA
  • NPI 1659376630
  Care Compare affiliation

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1235283292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919932",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328919932",
            "telephone_number": "904-493-3333",
            "fax_number": "904-493-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 ZEAGLER DR STE 101",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773860",
            "telephone_number": "386-325-2836",
            "fax_number": "386-326-2736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1465 Kingsley Ave",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320734504",
            "country_code": "US",
            "telephone_number": "904-644-0092",
            "fax_number": "904-644-0099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7011 A C Skinner Pkwy Ste 160",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322566953",
            "country_code": "US",
            "telephone_number": "904-493-3333",
            "fax_number": "904-493-2222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Ministry Pkwy",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "WI",
            "postal_code": "544765213",
            "country_code": "US",
            "telephone_number": "715-393-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURYADEVARA",
        "first_name": "SIVA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME116319",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME116319",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WI",
            "license": "13556",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008906600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14Q8K",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003135084A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "3400 Ministry Pkwy",
            "city": "Weston",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544765213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abigale Rose Such, OTR
• Harold Hayes Sullivan Jr., MD, MPH
• Joseph Wynn Sullivan, D.O.
• Sunrise Primary Care Inc
• Sunrise Primary Care Inc
• Kathleen Marie Tanner, LMT, LPN
• Lucien-Maximin Yanou Tchuisse, M.D.
• Ani Maria Tejada-Lipten, MD
• Sarah Ann Tellas, PT
• Tender Care Medical Services of St. Johns County, Inc.

• Interventional Cardiology Physician in Palatka, FL
• Providers in Palatka, FL by specialty
• Interventional Cardiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.