Varghese Kodiyan, LCSW,PA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW4420 Issued in FL

Practice address

1601 W Reynolds St
Plant City, FL 33563-4748

Phone

(813) 245-7326

Fax

(813) 964-0453

NPI assigned

Jun 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Varghese Kodiyan PA

  • Clinical Social Worker
  • Tampa, FL
  • NPI 1003175753
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326084435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 SHELLCRACKER CT",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131214",
            "telephone_number": "813-245-7326",
            "fax_number": "813-964-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W REYNOLDS ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335634748",
            "telephone_number": "813-245-7326",
            "fax_number": "813-964-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODIYAN",
        "first_name": "VARGHESE",
        "name_prefix": "Mr.",
        "credential": "LCSW,PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW4420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melonese King
• Christopher B. Kirby, MD
• Leigh Klein, DMD
• Lynn Kliem, ARNP
• Latisha M Knighten
• Brian J. Korte, M.D.
• KP Care Group, Inc
• Elizabeth Kripas, RN
• Kylie Jeanae Kropp
• Meena Kukreja

• Clinical Social Worker in Plant City, FL
• Providers in Plant City, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.