Individual provider Active NPI

Guhapriya Amaresan Venugopal, M.D.

  • Family Medicine Physician
  • Miramar, FL
National Provider Identifier
1376712141
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A70289 Issued in CA
Practice address
3601 SW 160TH Ave
Suite #250
Miramar, FL 33027-6308
Phone
(305) 866-9951
Fax
(305) 614-3352
NPI assigned
Feb 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A70289 CA
Family Medicine Physician 207Q00000X A70289 CA Primary

Addresses

Primary practice location

3601 SW 160TH Ave
Suite #250
Miramar, FL 33027-6308

Mailing address

19037 Owen Way
Cerritos, CA 90703-7347
Phone (562) 809-6076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081203000425 CA Practitioner - Family PracticePractitioner - Peripheral Vascular DiseasePractitioner - Physical Medicine and Rehabilitation 3870654346 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
70289CAMDPediatric Pharmacist
A70289CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of California, PC CurrentSince Jul 1, 2021 Accepting new patients

Locations

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1376712141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19037 OWEN WAY",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907037347",
            "telephone_number": "562-809-6076",
            "fax_number": "562-809-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE",
            "address_2": "SUITE #250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276308",
            "telephone_number": "305-866-9951",
            "fax_number": "305-614-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENUGOPAL",
        "first_name": "GUHAPRIYA",
        "middle_name": "AMARESAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-26",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A70289",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A70289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.