Sukumar Mathan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME80845 Issued in FL

Practice address

35600 US Hwy 27 North
Haines City, FL 33844-3731

Phone

(863) 866-9820

Fax

(863) 812-4455

NPI assigned

Jan 23, 2007

Last updated

Sep 1, 2021By 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 1

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Lake Wales Hospital, Lake Wales, FL, CCN 100099

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CJAGBA
• Direct secure messaging: sukumar.mathan@wellmed.eclinicaldirectplus.com

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.

• Optumcare Florida LLC

  dba Optum

  • General Practice Physician
  • Tampa, FL
  • NPI 1053384214

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Optumcare Florida, LLC

  dba Optum

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1659884294
  NPD
• Interventional Cardiology and Vascular Consultants, P.L.C.

  • Cardiovascular Disease Physician
  • Orlando, FL
  • NPI 1518175470
  NPD (past)
• Optumcare Florida Ci, LLC

  • Primary Care Clinic/Center
  • Winter Park, FL
  • NPI 1720506603
  NPD (past)
• Physicians Services LLC

  • Internal Medicine Physician
  • Lake Wales, FL
  • NPI 1205962131
  NPD (past)
• Physicians Services LLC

  • Internal Medicine Physician
  • Haines City, FL
  • NPI 1306003165
  NPD (past)
• Sunrise Pediatrics LLC

  • Pediatrics Physician
  • Lake Wales, FL
  • NPI 1891939989
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventhealth Polk South Inc

  dba AdventHealth Lake Wales

  • General Acute Care Hospital
  • Lake Wales, FL
  • NPI 1053972760
  Care Compare affiliation

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1386798452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35600 HWY 27",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338443731",
            "telephone_number": "863-866-9820",
            "fax_number": "863-812-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35600 US HWY 27 NORTH",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338443731",
            "telephone_number": "863-866-9820",
            "fax_number": "863-812-4455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6800 Cypress Gardens Blvd",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "338843523",
            "country_code": "US",
            "telephone_number": "863-268-7380",
            "fax_number": "863-808-1832",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1143 State Road 60 E",
            "address_purpose": "LOCATION",
            "city": "Lake Wales",
            "state": "FL",
            "postal_code": "338534320",
            "country_code": "US",
            "telephone_number": "863-679-8815",
            "fax_number": "863-679-8335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHAN",
        "first_name": "SUKUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME80845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259693800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manuel G Jain, MD, LLC
• Makeia Keshon Martin
• Marisa Martin
• Flavia Martinez Acosta
• Clovis Airton Martins Braga Jr.
• Vera Renita Mathis
• Gabriel A Matos, LMT
• Mitzy Mattei Rivera, APRN
• Maya Diagnostic Imaging, LLC
• Marilyn Maya

• Internal Medicine Physician in Haines City, FL
• Providers in Haines City, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.