P Konda MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME43981 Issued in FL

Legal business name

P KONDA MD PA

Practice address

13005 Southern Blvd
Suite 145
Loxahatchee, FL 33470-9206

Phone

(561) 798-5500

Fax

(561) 795-3341

NPI assigned

May 15, 2007

Last updated

Nov 7, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

DR. PRASAD KONDAAs reported in NPPES

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

Authorized official

Name

Prasad Konda, MDNPI 1598730079

Title

Owner

Phone

(561) 798-5500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Part of

P Konda MD PA

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Prasad Konda, M.D.

  • Specialist
  • Loxahatchee, FL
  • NPI 1598730079
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1376759316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD",
            "address_2": "SUITE 145",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709206",
            "telephone_number": "561-798-5500",
            "fax_number": "561-795-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD",
            "address_2": "SUITE 145",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709206",
            "telephone_number": "561-798-5500",
            "fax_number": "561-795-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P KONDA MD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR. PRASAD KONDA",
        "enumeration_date": "2007-05-15",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "KONDA",
        "authorized_official_first_name": "PRASAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-798-5500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME43981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Loxahatchee, FL
• Providers in Loxahatchee, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.