Individual provider Active NPI

Subadra Sivakumaran, MD

  • Family Medicine Physician
  • Ocala, FL
National Provider Identifier
1275592883
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0053303 Issued in FL
Practice address
2810 SE 3Rd CT
Ocala, FL 34471-0446
Phone
(352) 671-1111
Fax
(352) 671-1131
NPI assigned
Mar 22, 2006
Last updated
Feb 13, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0053303 FL Primary

Addresses

Primary practice location

2810 SE 3Rd CT
Ocala, FL 34471-0446

Mailing address

4520 NW 33Rd CT
Gainesville, FL 32606-5937
Phone (352) 671-1111

Other identifiers 3

IdentifierTypeStateIssuer
007295700MedicaidFL
07849OtherFLBCBS
07849AOtherFLMEDICARE PTAN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101021000336 FL Practitioner - Family Practice 6406049576 Reassigns benefits to 1 organization
Practice locations: Ocala, FL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0053303FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ocala Florida Physician Group CurrentSince Feb 18, 2022 Accepting new patients
SKS Medical PLLC Current Accepting new patients
Subadra Sivakumaran MD PA Family Medicine PastSince Aug 2, 2010 Accepting new patients
Ocala Physician Associates PA PastSince Oct 14, 2018 Accepting new patients

Locations

2810 SE 3rd Ct
Ocala, FL 34471
Phone (352) 732-0122

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1275592883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 NW 33RD CT",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326065937",
            "telephone_number": "352-671-1111",
            "fax_number": "352-671-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 SE 3RD CT",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344710446",
            "telephone_number": "352-671-1111",
            "fax_number": "352-671-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVAKUMARAN",
        "first_name": "SUBADRA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0053303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007295700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "07849",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "07849A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.