NPIMap

Organization Active NPI

Vinayak V Purandare MD PL

  • Nephrology Physician
  • Ormond Beach, FL
National Provider Identifier
1457508343
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME0045136 Issued in FL
Legal business name
VINAYAK V PURANDARE MD PL
Practice address
401 Lakebridge Plaza Dr
Ormond Beach, FL 32174-5157
Phone
(386) 672-8595
Fax
(386) 677-4987
NPI assigned
Aug 21, 2008
Last updated
Jun 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Vinayak V Purandare, M.D.NPI 1265429500
Title
Owner
Phone
(386) 672-8595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME0045136 FL Primary

Addresses

Primary practice location

401 Lakebridge Plaza Dr
Ormond Beach, FL 32174-5157

Mailing address

305 Memorial Medical Parkway, Suite 507
Daytona Beach, FL 32117
Phone (386) 672-8595

Other identifiers 1

IdentifierTypeStateIssuer
048136000MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1219276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1457508343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PARKWAY, SUITE 507",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32117",
            "telephone_number": "386-672-8595",
            "fax_number": "386-677-4987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 LAKEBRIDGE PLAZA DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745157",
            "telephone_number": "386-672-8595",
            "fax_number": "386-677-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINAYAK V PURANDARE MD PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-21",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "PURANDARE",
        "authorized_official_first_name": "VINAYAK",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-672-8595",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME0045136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048136000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.