Individual provider Active NPI

Rama Kantamneni Krishna, MD

  • Interventional Cardiology Physician
  • Tavares, FL
National Provider Identifier
1326297813
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME117201 Issued in FL
Practice address
1879 Nightingale LN Ste C1
Tavares, FL 32778-4363
Phone
(352) 742-1171
NPI assigned
Sep 9, 2008
Last updated
Jun 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME117201 FL
Internal Medicine Physician 207R00000X MD443202 PA
Cardiovascular Disease Physician 207RC0000X ME117201 FL
Interventional Cardiology Physician 207RI0011X ME117201 FL Primary

Addresses

Primary practice location

1879 Nightingale LN Ste C1
Tavares, FL 32778-4363

Mailing address

1879 Nightingale LN Ste C1
Tavares, FL 32778-4363
Phone (352) 742-1171

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
I20170616001546 FL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 2860760717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

1879 Nightingale LN
Suite A1 and C1
Tavares, FL 32778-4363
Phone (352) 742-1171

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting91
Leg revascularization (restoring blood flow)13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD443202PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Healthcare Partners, Inc Internal Medicine CurrentSince Jun 18, 2023 Accepting new patients
Lake Cardiovascular Diagnostic Center L.L.C Cardiovascular Disease PastSince Jul 1, 2017 Accepting new patients

Locations

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

1879 Nightingale Ln
Ste A1
Tavares, FL 32778
Phone (352) 401-1919

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rkrishna58821@adventhealth.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1326297813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1879 NIGHTINGALE LN STE C1",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784363",
            "telephone_number": "352-742-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1879 NIGHTINGALE LN STE C1",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784363",
            "telephone_number": "352-742-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNA",
        "first_name": "RAMA",
        "middle_name": "KANTAMNENI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-09",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME117201",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD443202",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME117201",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME117201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.