Individual provider Active NPI

Sushma Koneru, MD

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Orlando, FL
National Provider Identifier
1457572547
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
ME131009 Issued in FL
Practice address
1723 Lucerne Ter Ste 100
Orlando, FL 32806-2916
Phone
(407) 738-4200
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 26298 IA
Internal Medicine Physician 207R00000X 125-050062 IL
Cardiovascular Disease Physician 207RC0000X ME131009 FL
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X ME131009 FL Primary

Addresses

Primary practice location

1723 Lucerne Ter Ste 100
Orlando, FL 32806-2916

Mailing address

1723 Lucerne Ter Ste 100
Orlando, FL 32806-2916
Phone (407) 738-4200

Other identifiers 4

IdentifierTypeStateIssuer
020180500MedicaidFL
1457572547MedicaidIA
P01372068OtherIARR MEDICARE
036120390MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170411000353 FL Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1759453525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant CardiologyAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2111 SW 20TH PL
Ocala, FL 34471-7734
Phone (352) 622-4251

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-050062ILMDInternal Medicine Physician
26298IAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Institute of Central Florida, LLC Internal Medicine CurrentSince May 1, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 2, 2017 Accepting new patients
Cardiovascular Institute of Central Florida, LLC CurrentSince May 1, 2023 Accepting new patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Mar 2, 2017 Accepting new patients

Locations

805 Oakley Seaver Dr
Ste A
Clermont, FL 34711
Phone (407) 652-6000

207 Park Place Blvd
Ste 3
Kissimmee, FL 34741
Phone (402) 870-5050

795 Primera Blvd
Ste 1021
Lake Mary, FL 32746

521 W State Road 434
Ste 307308
Longwood, FL 32750

2111 SW 20th Pl
Ocala, FL 34471
Phone (352) 547-3399

6424 Alexandra Louise Dr
Ste 480
Orlando, FL 32827

7148 Curry Ford Rd
Ste 200
Orlando, FL 32822
Phone (407) 273-1357

7301 Stonerock Cir
Ste 1
Orlando, FL 32819
Phone (352) 512-9139

2859 Delaney Ave
Ste 100
Orlando, FL 32806

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1723 Lucerne Ter
Ste 100
Orlando, FL 32806

1222 S Orange Ave
Orlando, FL 32806
Phone (407) 649-6907

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: sushma.koneru.1@29679.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1457572547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 LUCERNE TER STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062916",
            "telephone_number": "407-738-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 LUCERNE TER STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062916",
            "telephone_number": "407-738-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONERU",
        "first_name": "SUSHMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IA",
            "license": "26298",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125-050062",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME131009",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "FL",
            "license": "ME131009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020180500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457572547",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01372068",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036120390",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.