Active NPI
Kshemal Mankodi, M.D.
- Family Medicine Physician
- Wesley Chapel, FL
National Provider Identifier
1447292172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME78449
- Practice address
- 28959 Wesley Chapel Blvd
Wesley Chapel, FL 33543-3218 - Phone
- (813) 994-4749
- Fax
- (813) 994-0474
- NPI assigned
- Jun 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME78449 | FL | Primary |
Addresses
Primary practice location
28959 Wesley Chapel Blvd
Wesley Chapel, FL 33543-3218
Mailing address
PO Box 46068
Tampa, FL 33646-0101
Phone (813) 994-4749
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01-09835 | Other | FL | UNITED HEALTHCARE |
| 2095583 | Other | FL | FIRST HEALTH |
| 00-00649 | Other | FL | UNITED MEDICARE COMPLETE |
| 200901200 | Other | FL | DEPARTMENT OF LABOUR ACS |
| 885456 | Other | FL | USA MANAGED CARE ORG. |
| 213352 | Other | FL | WELLCARE |
| 7732052 | Other | FL | AETNA |
| 213352 | Other | FL | STAYWELL |
| 213352 | Other | FL | HEALTHEASE |
| 214085-09 | Other | FL | AMERIGROUP |
| 257244300 | Medicaid | FL | |
| 287443 | Other | FL | AVMED |
| 06089 | Other | FL | UNIVERSAL HEALTHCARE |
| 15107 | Other | FL | ALL FLORIDA PPO |
| 49434 | Other | FL | BLUE CROSS BLUE SHIELD |
| 5893655 | Other | FL | CIGNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320364800000",
"number": "1447292172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 46068",
"city": "TAMPA",
"state": "FL",
"postal_code": "336460101",
"telephone_number": "813-994-4749",
"fax_number": "813-994-0474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28959 WESLEY CHAPEL BLVD",
"city": "WESLEY CHAPEL",
"state": "FL",
"postal_code": "335433218",
"telephone_number": "813-994-4749",
"fax_number": "813-994-0474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANKODI",
"first_name": "KSHEMAL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-10",
"last_updated": "2011-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME78449",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "01-09835",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "2095583",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED MEDICARE COMPLETE",
"identifier": "00-00649",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF LABOUR ACS",
"identifier": "200901200",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "USA MANAGED CARE ORG.",
"identifier": "885456",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "213352",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7732052",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STAYWELL",
"identifier": "213352",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHEASE",
"identifier": "213352",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "214085-09",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "257244300",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "287443",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERSAL HEALTHCARE",
"identifier": "06089",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALL FLORIDA PPO",
"identifier": "15107",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "49434",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "5893655",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wesley Chapel, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.