NPIMap

Organization Active NPI

West Florida Medical Associates P a

  • Internal Medicine Physician
  • Beverly Hills, FL
National Provider Identifier
1265515001
Registry record updated Mar 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WEST FLORIDA MEDICAL ASSOCIATES P A
Practice address
3404 C N Lecanto Hwy
Beverly Hills, FL 34465
Phone
(352) 746-1558
Fax
(352) 746-3838
NPI assigned
Oct 23, 2006
Last updated
Mar 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2013

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

Authorized official

Name
Dr. Mariananda P. Kumar, M.D.
Title
M.D. / President
Phone
(352) 746-1558

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X FL
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X FL
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X FL Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X FL
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X FL
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X FL
Clinical Medical Laboratory 291U00000X 800008970 FL
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X FL
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X FL

Addresses

Primary practice location

3404 C N Lecanto Hwy
Beverly Hills, FL 34465

Mailing address

PO Box 640573
Beverly Hills, FL 34464-0573
Phone (352) 746-1558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20040401000131 FL Part B Supplier - Clinic/Group Practice 9032023221 Receives reassigned benefits from 70 practitioners
2 other NPIs on this enrollment
Practice locations: Inglis, FL; Inverness, FL; Citrus Springs, FL; Lecanto, FL; Wildwood, FL; Hernando, FL; Floral City, FL; Dunnellon, FL…
O20091017000048 FL Part A Provider - Rural Health Clinic 9032023221 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Inverness, FL
O20111019000136 FL Part A Provider - Rural Health Clinic 9032023221 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dunnellon, FL
O20180613003106 FL Part A Provider - Rural Health Clinic 9032023221 Practice locations: Inverness, FL

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1265515001. Details of each certification follow.

Rural health clinic certification: CCN 103834

Legal name
WEST FLORIDA MEDICAL ASSOCIATES, PA
Doing business as
COMPREHENSIVE PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 17, 2010
Last certification
May 19, 2022
Ownership / control type
1A
Organization structure
CorporationProprietary
Incorporated
Jun 5, 1997 in FL
Enrollment address
213 S Pine Ave
Inverness, FL 34452-4830

Rural health clinic certification: CCN 103922

Legal name
WEST FLORIDA MEDICAL ASSOCIATES, PA
Doing business as
DEVEN MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 22, 2012
Last certification
Nov 29, 2023
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Jul 21, 1997 in FL
Enrollment address
11707 N Williams Street
Suite 2
Dunnellon, FL 34432-5855

Rural health clinic certification: CCN 683833

Legal name
WEST FLORIDA MEDICAL ASSOCIATES, PA
Doing business as
BHADRESH PATEL- INVERNESS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 4, 2019
Last certification
Apr 8, 2026
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Apr 13, 2018 in FL
Enrollment address
801 Medical CT E
Inverness, FL 34452-4623

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3400 N Lecanto Hwy
#A
Beverly Hills, FL 34465
Phone (352) 746-2227

3737 N Lecanto Hwy
Beverly Hills, FL 34465
Phone (352) 746-1515

3775 N Lecanto Hwy
Beverly Hills, FL 34465
Phone (352) 746-0600

7647 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 795-1718

7647 W Gulf To Lake Hwy
Ste 6
Crystal River, FL 34429
Phone (352) 795-1718

2623 N Forest Ridge Blvd
Hernando, FL 34442
Phone (352) 746-4684

7991 S Suncoast Blvd
Homosassa Springs, FL 34446
Phone (352) 344-8080

41 N Inglis Ave
Inglis, FL 34449
Phone (352) 447-3031

3733 E Gulf To Lake Hwy
Inverness, FL 34453
Phone (352) 341-5520

3733 E Gulf To Lake Hwy
Ste A
Inverness, FL 34453
Phone (352) 341-5520

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Hasibul Hassan Khan Individual 5% Or Greater Direct Ownership Interest Jan 1, 2012 100%
W-2 Managing Employee Apr 2, 2008
Uday Hiremath Individual 5% Or Greater Direct Ownership Interest Oct 13, 2022 100%
Ulhas Tarikere Deven Individual Corporate Officer Oct 12, 2011
Corporate Director Oct 12, 2011
Sridevi Deven Individual W-2 Managing Employee Oct 12, 2011
Bhadresh Patel Individual 5% Or Greater Direct Ownership InterestOwner Apr 13, 2018 100%
W-2 Managing EmployeeOwner Apr 13, 2018 100%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 77

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 77

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362614400000",
    "number": "1265515001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640573",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344640573",
            "telephone_number": "352-746-1558",
            "fax_number": "352-746-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 C N LECANTO HWY",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "34465",
            "telephone_number": "352-746-1558",
            "fax_number": "352-746-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST FLORIDA MEDICAL ASSOCIATES P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-03-07",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "MARIANANDA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "M.D. / PRESIDENT",
        "authorized_official_telephone_number": "352-746-1558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800008970",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, FL

Sources for this page

Verify at the official NPI Registry.