Active NPI
Riad K. Bankusli, MD
- Internal Medicine Physician
- Largo, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME153794
- Practice address
- 1301 2ND Ave SW
Largo, FL 33770-2298 - Phone
- (727) 584-7706
- Fax
- (727) 581-3727
- NPI assigned
- Apr 20, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME153794 | FL | Primary |
Addresses
Primary practice location
1301 2ND Ave SW
Largo, FL 33770-2298
Mailing address
1301 2ND Ave SW
Largo, FL 33770-2298
Phone (727) 584-7706
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| KXW4L | Other | FL | FLORIDA BLUE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1839 Central Ave
St Petersburg, FL 33713-8900
1839 Central Ave
St Petersburg, FL 33713-9089
Phone (727) 322-1054
Hospital & facility affiliations
- Patients First Homecare, LLC
- Morton Plant Hospital
- HCA Florida Largo Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 70.73 of 100
- Quality
- 8.6
- Promoting interoperability
- 90
- Improvement activities
- 40
- Cost
- 68.84
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME153794 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Health Care of Pinellas LLC | Internal Medicine | Current | Accepting new patients |
| Sunstate Physicians LLC | Internal Medicine | Current | Accepting new patients |
| Professional Health Care of Pinellas Inc. | Current | Accepting new patients | |
| Lifestream Behavioral Health | Past | Accepting new patients |
Locations
2234 N Federal Hwy
Boca Raton, FL 33431
Phone (561) 306-5469
801 West Bay Dr
Ste 321
Largo, FL 33770
Phone (561) 302-6086
1301 2nd Ave SW
#314
Largo, FL 33770
1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EIJHAA
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.
-
- Internal Medicine Physician
- St Petersburg, FL
- NPI 1881647253
-
- Chiropractor
- St Petersburg, FL
- NPI 1568970903
-
- Psychiatry Physician
- Largo, FL
- NPI 1841083912
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Largo, FL
- NPI 1144274879
-
- General Acute Care Hospital
- Clearwater, FL
- NPI 1376529743
-
- Home Health Agency
- Clearwater, FL
- NPI 1457186975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640822400000",
"number": "1497242804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 2ND AVE SW",
"city": "LARGO",
"state": "FL",
"postal_code": "337702298",
"telephone_number": "727-584-7706",
"fax_number": "727-581-3727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 2ND AVE SW",
"city": "LARGO",
"state": "FL",
"postal_code": "337702298",
"telephone_number": "727-584-7706",
"fax_number": "727-581-3727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANKUSLI",
"first_name": "RIAD",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-20",
"last_updated": "2021-12-30",
"certification_date": "2021-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME153794",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA BLUE",
"identifier": "KXW4L",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Largo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.