Individual provider Active NPI

Bruno Shankar Subbarao, D.O.

  • Physical Medicine & Rehabilitation Physician
  • South Miami, FL
National Provider Identifier
1407191885
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
OS13628 Issued in FL
Practice address
7031 SW 62ND Ave
South Miami, FL 33143-4701
Phone
(305) 284-7500
NPI assigned
Dec 11, 2012
Last updated
Jan 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X OS13628 FL Primary

Addresses

Primary practice location

7031 SW 62ND Ave
South Miami, FL 33143-4701

Mailing address

533 NE 3Rd Ave
Apt 505
Fort Lauderdale, FL 33301-3283
Phone (412) 478-9148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20241021003620 AZ Practitioner - Physical Medicine and Rehabilitation 9638473929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Lake Erie College of Osteopathic Medicine, Bradenton, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Az Rehab Consultants LLCGroup PAC ID 4385023159, 15 clinicians

Practice addresses (Care Compare)

1515 W Chandler Blvd
Chandler, AZ 85224-6141
Phone (602) 594-5400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Az Rehab Consultants, LLC Physical Medicine & Rehabilitation CurrentSince Oct 1, 2024 Accepting new patients
Clearsky Rehabilitation Hospital of West Valley, LLC Past Accepting new patients
Bruno Subbarao PLLC Physical Medicine & Rehabilitation Past Accepting new patients

Locations

1515 W Chandler Blvd
Chandler, AZ 85224
Phone (480) 389-9529

16772 W Bell Rd
Ste 110619
Surprise, AZ 85374
Phone (602) 616-7047

Organizations & group practices 3

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 1

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": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1407191885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 NE 3RD AVE",
            "address_2": "APT 505",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333013283",
            "telephone_number": "412-478-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7031 SW 62ND AVE",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434701",
            "telephone_number": "305-284-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBBARAO",
        "first_name": "BRUNO",
        "middle_name": "SHANKAR",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-11",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "OS13628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.