Individual provider Active NPI

Venkata R. Yerramilli, M.D.

  • Family Medicine Physician
  • Bonita Springs, FL
National Provider Identifier
1346203775
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME109954 Issued in FL
Practice address
3302 Bonita Beach Rd Ste 170
Bonita Springs, FL 34134-4217
Phone
(239) 624-1050
Fax
(239) 624-1051
NPI assigned
Apr 7, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 ME109954 FL Primary

Addresses

Primary practice location

3302 Bonita Beach Rd Ste 170
Bonita Springs, FL 34134-4217

Mailing address

3302 Bonita Beach Rd
#170
Bonita Springs, FL 34134-4216
Phone (239) 624-1050

Other identifiers 3

IdentifierTypeStateIssuer
003569500MedicaidFL
14CR6OtherFLBCBS
EZ010XOtherFLBCBS

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
I20110708000234 FL Practitioner - Family Practice 1759348154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.25 of 100Reported as apm
Quality
87.73
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nchmd, Inc CurrentSince Oct 1, 2014 Accepting new patients
Nchmd Inc Current Accepting new patients
Landmark Hospital of Southwest Florida, LLC CurrentSince Oct 1, 2014 Accepting new patients
Tri City Medical Hospitalists LLC Past Accepting new patients

Locations

3302 Bonita Beach Rd
Ste 170
Bonita Springs, FL 34134
Phone (239) 624-1050

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

Interoperability endpoints

  • Direct secure messaging: vyerramilli23383@nchhealthcaresystem.direct-ci.com

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346203775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 BONITA BEACH RD",
            "address_2": "#170",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344216",
            "telephone_number": "239-624-1050",
            "fax_number": "239-624-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 BONITA BEACH RD STE 170",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344217",
            "telephone_number": "239-624-1050",
            "fax_number": "239-624-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YERRAMILLI",
        "first_name": "VENKATA",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME109954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003569500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14CR6",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "EZ010X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

Verify at the official NPI Registry.