Individual provider Active NPI

Lakshmangowda Maragondanahalli, M D

  • Internal Medicine Physician
  • Anderson, SC
National Provider Identifier
1366689028
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
32536 Issued in SC
Practice address
819 N Fant St
Anderson, SC 29621-5717
Phone
(864) 261-1800
NPI assigned
Jan 15, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 32536 SC Primary

Addresses

Primary practice location

819 N Fant St
Anderson, SC 29621-5717

Mailing address

819 N Fant St
Anderson, SC 29621-5717
Phone (864) 261-1800

Other identifiers 3

IdentifierTypeStateIssuer
325366MedicaidSC
CJ2703OtherSCRR MEDICARE
P00892002OtherSCRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101108000764 SC Practitioner - Internal Medicine 5193910891 Reassigns benefits to 3 organizations
I20240311000045 FL Practitioner - Internal Medicine 5193910891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians of Florida VI LLCGroup PAC ID 1759802333, 141 clinicians
24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

4725 N Federal Hwy
Fort Lauderdale, FL 33308-4603
Phone (954) 771-8000

800 N Fant St
Anderson, SC 29621-5708
Phone (770) 740-0895

955 Ribaut Rd
Beaufort, SC 29902-5441
Phone (843) 522-5005

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as group
Quality
77.5
Improvement activities
40
Cost
74.58

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anmed Health Current Accepting new patients
24 On Physicians, PC CurrentSince Nov 12, 2018 Accepting new patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Feb 29, 2024 Accepting new patients
Anmed Health CurrentSince Mar 22, 2017 Accepting new patients
Sound Physicians of Florida VI LLC Internal Medicine CurrentSince Feb 1, 2025 Accepting new patients
Anmed Health CurrentSince Jul 18, 2010 Accepting new patients
Diagnostic Radiology of Anderson, P.a. Current Accepting new patients
24 On Physicians, P.C. CurrentSince Nov 12, 2018 Accepting new patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Feb 29, 2024 Accepting new patients
Anmed Health CurrentSince Jul 18, 2010 Accepting new patients
Piedmont Pathology Associates PA Current Accepting new patients
Anmed Health Past Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

318 Maxwell Rd
Ste 500
Alpharetta, GA 30009
Phone (770) 274-0473

703 N Fant St
Anderson, SC 29621
Phone (864) 225-5059

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

819 N Fant St
Anderson, SC 29621
Phone (864) 216-1800

1100 W Franklin St
Anderson, SC 29624
Phone (864) 224-0822

800 N Fant St
Ste A
Anderson, SC 29621
Phone (864) 225-5131

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Organizations & group practices 12

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.

Hospital & facility affiliations 7

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": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1366689028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215717",
            "telephone_number": "864-261-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215717",
            "telephone_number": "864-261-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAGONDANAHALLI",
        "first_name": "LAKSHMANGOWDA",
        "credential": "M D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-15",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "32536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325366",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CJ2703",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00892002",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.