NPIMap

Organization Active NPI

Cardiac Clinic, M.D., P.a.

Doing business as Cardiac Clinic

  • Interventional Cardiology Physician
  • Kissimmee, FL
National Provider Identifier
1457319329
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
CARDIAC CLINIC, M.D., P.A.
Doing business as
Cardiac Clinic
Practice address
311 W Oak St
Kissimmee, FL 34741-4421
Phone
(407) 933-1423
Fax
(407) 933-7901
NPI assigned
May 2, 2006
Last updated
Oct 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Authorized official

Name
Padma K Raju, MDNPI 1992890685
Title
President
Phone
(407) 933-7309

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU
Clinical Cardiac Electrophysiology Physician 207RC0001X NU
Interventional Cardiology Physician 207RI0011X NU Primary
Vascular Surgery Physician 2086S0129X NU

Addresses

Primary practice location

311 W Oak St
Kissimmee, FL 34741-4421

Mailing address

311 W Oak St
Kissimmee, FL 34741-4421
Phone (407) 933-1423

Other practice location 1

510 Cypress Pkwy
Kissimmee, FL 34759-3310
Phone (407) 933-1423

Other practice location 2

2801 17th St Ste 202
Saint Cloud, FL 34769-4939
Phone (407) 933-1423

Other practice location 3

400 Celebration Pl Ste A120
Celebration, FL 34747-4970
Phone (407) 933-1423

Other names 1

  • CARDIAC CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727001058 FL Part B Supplier - Clinic/Group Practice 1951371038 Receives reassigned benefits from 11 practitioners
Practice locations: Kissimmee, FL; Orlando, FL; Poinciana, FL; Saint Cloud, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0942834Cardiac Clinic311 West Oak Street, Kissimmee, FL 34741Certificate of waiverMar 17, 2028

National Provider Directory

National Provider Directory

Locations

1012 Cypress Pkwy
Poinciana, FL 34759
Phone (470) 933-1423

510 Cypress Pkwy
Poinciana, FL 34759

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791849600000",
    "number": "1457319329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414421",
            "telephone_number": "407-933-1423",
            "fax_number": "407-933-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414421",
            "telephone_number": "407-933-1423",
            "fax_number": "407-933-7901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Cypress Pkwy",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347593310",
            "country_code": "US",
            "telephone_number": "407-933-1423",
            "fax_number": "407-933-7901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2801 17th St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "FL",
            "postal_code": "347694939",
            "country_code": "US",
            "telephone_number": "407-933-1423",
            "fax_number": "407-933-7901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Celebration Pl Ste A120",
            "address_purpose": "LOCATION",
            "city": "Celebration",
            "state": "FL",
            "postal_code": "347474970",
            "country_code": "US",
            "telephone_number": "407-933-1423",
            "fax_number": "407-933-7901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CARDIAC CLINIC, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A",
        "authorized_official_last_name": "RAJU",
        "authorized_official_first_name": "PADMA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-933-7309",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CARDIAC CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.