Padmanabha Raju Mungara, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ACN218 Issued in FL

Practice address

647 1St Ave N
St Petersburg, FL 33701-3601

Phone

(727) 582-7712

NPI assigned

Apr 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Florida Department of Health

  dba Manatee County Health Department

  • Public Health or Welfare Agency
  • Bradenton, FL
  • NPI 1982673737
  Medicare reassignment NPD
• Florida Department of Health

  dba Levy County Health Department

  • Public Health or Welfare Agency
  • Bronson, FL
  • NPI 1154395390
  NPD

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356463939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 1ST AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013601",
            "telephone_number": "727-582-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 1ST AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013601",
            "telephone_number": "727-582-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNGARA",
        "first_name": "PADMANABHA RAJU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ACN218",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "056853",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danah Lynn Mulqueen, BCBA
• Multi-Health Purpose Rehab
• Abenezer Kibru Mulugeta, MD
• Joanne Frances Mumbey, RDN
• Mundial Medical Clinic LLC
• Vanessa I Muniz, PA-C
• Shawntae N Munn, APRN
• Carlos Jose Munoz, M.D.
• Munroe Wellness
• Ann Fraser Munroe, DC

• Family Medicine Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Family Medicine Physician 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.