Individual provider Active NPI

Jyothi Raviprasad, M.D.

  • Anesthesiology Physician
  • Maitland, FL
National Provider Identifier
1275616278
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME 94163 Issued in FL
Practice address
2450 Maitland Center Pkwy
Suite 100
Maitland, FL 32751-4140
Phone
(407) 875-0296
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME 94163 FL Primary

Addresses

Primary practice location

2450 Maitland Center Pkwy
Suite 100
Maitland, FL 32751-4140

Mailing address

213 Colony Springs LN
Maitland, FL 32751-6102
Phone (407) 644-0890

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
I20070710000641 FL Practitioner - Anesthesiology 9335136860 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 94163FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Professional Services, Inc. Anesthesiology CurrentSince May 1, 2008 Accepting new patients
Lake Mary Surgery Center LLC Current Accepting new patients
Orange City Anesthesia Services LLC Anesthesiology CurrentSince Sep 7, 2017 Accepting new patients
Shaw Anesthesia Services, PA Past Accepting new patients
Associated Healthcare Systems of Randolph County, Inc. Past Accepting new patients
Kalamazoo Anesthesiology P C Anesthesiology Past Accepting new patients

Locations

460 Saint Charles Ct
Lake Mary, FL 32746
Phone (407) 585-0260

2450 Maitland Center Pkwy
Ste 100
Maitland, FL 32751
Phone (407) 875-0296

975 Town Center Dr
Ste 100
Orange City, FL 32763
Phone (386) 456-5247

2821 Proctor Rd
Sarasota, FL 34231
Phone (941) 870-1872

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1275616278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 COLONY SPRINGS LN",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327516102",
            "telephone_number": "407-644-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 MAITLAND CENTER PKWY",
            "address_2": "SUITE 100",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514140",
            "telephone_number": "407-875-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVIPRASAD",
        "first_name": "JYOTHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME 94163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.