Active NPI
Thejaswi Bandikatla
- Internal Medicine Physician
- Maitland, FL
National Provider Identifier
1346595139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 135000
- Practice address
- 590 Ruby CT
Maitland, FL 32751-5226 - Phone
- (407) 677-4867
- NPI assigned
- Jul 17, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 135000 | FL | Primary |
Addresses
Primary practice location
590 Ruby CT
Maitland, FL 32751-5226
Mailing address
590 Ruby CT
Maitland, FL 32751-5226
Phone (407) 677-4867
Other practice location 1
33 W 125th St
New York, NY 10027-4512
Phone (860) 985-1772
Other practice location 2
2555 S Volusia Ave
Orange City, FL 32763
Phone (386) 774-0401
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Ability Health Services, IncAbility Health Services and Rehabilitation LP
Practice addresses (Care Compare)
1200 Lexington Green LN
Sanford, FL 32771-1013
590 Ruby CT
Maitland, FL 32751-5226
Phone (407) 677-4867
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 135000 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Florida Medical Associates, PA | Internal Medicine | Current | Accepting new patients |
| West Florida Medical Associates P a | Internal Medicine | Current | Accepting new patients |
| Lake Howell Family Medicine Associates | Current | Accepting new patients | |
| Central Florida Medical Associates, Inc | Internal Medicine | Past | Accepting new patients |
Locations
20021 SW 111th Pl
Dunnellon, FL 34432
Phone (352) 465-1199
590 Ruby Ct
Maitland, FL 32751
Phone (407) 677-4867
Interoperability endpoints
- tbandikatla@2ac616a7.micromddirect.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 and National Provider Directory roles.
-
- Family Medicine Physician
- Maitland, FL
- NPI 1497713390
-
- Internal Medicine Physician
- Beverly Hills, FL
- NPI 1265515001
-
- Family Medicine Physician
- Inverness, FL
- NPI 1770724130
Internal Medicine
-
- Internal Medicine Physician
- Orange City, FL
- NPI 1528111085
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
-
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
-
- Home Health Agency
- Orlando, FL
- NPI 1730647041
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609804800000",
"number": "1346595139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 RUBY CT",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327515226",
"telephone_number": "407-677-4867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 RUBY CT",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327515226",
"telephone_number": "407-677-4867"
}
],
"practiceLocations": [
{
"address_1": "33 W 125th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100274512",
"country_code": "US",
"telephone_number": "860-985-1772",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2555 S Volusia Ave",
"address_purpose": "LOCATION",
"city": "Orange City",
"state": "FL",
"postal_code": "32763",
"country_code": "US",
"telephone_number": "386-774-0401",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BANDIKATLA",
"first_name": "THEJASWI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-17",
"last_updated": "2021-01-05",
"certification_date": "2021-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "135000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maitland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.