Individual provider Active NPI

Bala K Nandigam, MD

  • Cardiovascular Disease Physician
  • Port Charlotte, FL
National Provider Identifier
1306879119
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME48592 Issued in FL
Practice address
2400 Harbor Blvd
Suite 12
Port Charlotte, FL 33952-5052
Phone
(941) 625-6187
Fax
(941) 625-7887
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME48592 FL Primary

Addresses

Primary practice location

2400 Harbor Blvd
Suite 12
Port Charlotte, FL 33952-5052

Mailing address

2400 Harbor Blvd
Suite 12
Port Charlotte, FL 33952-5052
Phone (941) 625-6187

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
I20100824001204 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5698675874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbor Cardiology and Vascular Center, PAGroup PAC ID 3274433453, 2 clinicians

Practice addresses (Care Compare)

2400 Harbor Blvd
Port Charlotte, FL 33952-5038

2400 Harbor Blvd
Suite 12And16
Port Charlotte, FL 33952-5052
Phone (941) 625-6187

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1306879119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 HARBOR BLVD",
            "address_2": "SUITE 12",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525052",
            "telephone_number": "941-625-6187",
            "fax_number": "941-625-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HARBOR BLVD",
            "address_2": "SUITE 12",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525052",
            "telephone_number": "941-625-6187",
            "fax_number": "941-625-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDIGAM",
        "first_name": "BALA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME48592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.