Mythili Penugonda, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

140771 Issued in FL

Practice address

309 SW 145TH Ter
Pembroke Pines, FL 33027-1443

Phone

(888) 663-6331

Fax

(415) 252-7176

NPI assigned

Apr 18, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, DC2 enrollments

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 2

Specialty

Family Practice

Education

Florida International Univ, College of Medicine, 2013

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• One Medstar Primary Care LLC

  • Family Medicine Physician
  • Washington, DC
  • NPI 1417571530
  Medicare reassignment
• Baptist Health Medical Group Physicians LLC

  • Specialist
  • Miami, FL
  • NPI 1891893343
  NPD (past)

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1447784269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 SW 145TH TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271443",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6100 Hollywood Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330247982",
            "country_code": "US",
            "telephone_number": "844-665-4831",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "86 SW 8th St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331303784",
            "country_code": "US",
            "telephone_number": "888-663-6331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 Connecticut Ave NW Ste 1250",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200361728",
            "country_code": "US",
            "telephone_number": "202-627-1901",
            "fax_number": "415-252-7176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENUGONDA",
        "first_name": "MYTHILI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V2213",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "140771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronoel Penalver, M.D
• Elizabeth Carmen Penela, PH.D.
• Youmeizi Peng
• Isabella Penso Mota, RD, LDN
• Penstar Provider Network LLC
• Peony Home Aide Agency LLC
• People Empowering People, PA
• Cindy Pepin, FNP
• Junior Manuel Peralta Pena, NURSE PRACTITIONER
• Dihloren Antonia Peralta-Lee, MD

• Family Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.