NPIMap

Organization Active NPI

Sunergy Physicians LLC

  • Internal Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1386247658
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SUNERGY PHYSICIANS LLC
Practice address
4820 5TH Ave N
St Petersburg, FL 33713-7218
Phone
(727) 280-5767
Fax
(727) 280-5767
NPI assigned
Nov 19, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Authorized official

Name
Dr. Swetaben Patidar, MDNPI 1144750258
Title
Member
Phone
(609) 350-8949

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4820 5TH Ave N
St Petersburg, FL 33713-7218

Mailing address

5260 78TH Ave N Unit 2616
Pinellas Park, FL 33780-8106
Phone (727) 280-5767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201214000039 FL Part B Supplier - Clinic/Group Practice 0547672776 Receives reassigned benefits from 11 practitioners
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

5260 78th Ave N
Unit 2616
Pinellas Park, FL 33780

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615420800000",
    "number": "1386247658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5260 78TH AVE N UNIT 2616",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337808106",
            "telephone_number": "727-280-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 5TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337137218",
            "telephone_number": "727-280-5767",
            "fax_number": "727-280-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNERGY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-19",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A",
        "authorized_official_last_name": "PATIDAR",
        "authorized_official_first_name": "SWETABEN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "609-350-8949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.