NPIMap

Individual provider Active NPI

Vijayasekhara Reddy Kalakata, MD

  • Physical Medicine & Rehabilitation Physician
  • Crystal River, FL
National Provider Identifier
1407039860
Registry record updated Jan 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME101929 Issued in FL
Practice address
690 NE 3Rd Ave Ste 104
Crystal River, FL 34428-3541
Phone
(352) 365-0045
Fax
(353) 364-0047
NPI assigned
Dec 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2013

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 045574 CT
Physical Medicine & Rehabilitation Physician 208100000X ME101929 FL Primary

Addresses

Primary practice location

690 NE 3Rd Ave Ste 104
Crystal River, FL 34428-3541

Mailing address

208 S Harrison St
Beverly Hills, FL 34465-4061
Phone (352) 365-0045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091022000600 FL Practitioner - Physical Medicine and Rehabilitation 0840337994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
State University of New York Downstate Medical Center, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

609 NE 3Rd Ave
Suite 104
Crystal River, FL 34428-3541

690 NE 3Rd Ave
Suite 104
Crystal River, FL 34428-3541
Phone (352) 364-0045

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
045574CTMDPhysical Medicine & Rehabilitation Physician
ME101929FLMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summerfield Medical Clinic MD PA CurrentSince Jun 1, 2015 Accepting new patients

Locations

13055 Summerfield Square Dr
Riverview, FL 33578
Phone (813) 741-2473

13055 Summerfield Square Dr
#D
Riverview, FL 33578
Phone (813) 741-2473

Organizations & group practices 2

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.

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": "1196985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1407039860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 S HARRISON ST",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344654061",
            "telephone_number": "352-365-0045",
            "fax_number": "353-364-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 NE 3RD AVE STE 104",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344283541",
            "telephone_number": "352-365-0045",
            "fax_number": "353-364-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALAKATA",
        "first_name": "VIJAYASEKHARA",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-07",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CT",
            "license": "045574",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME101929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal River, FL

Sources for this page

Verify at the official NPI Registry.