NPIMap

Individual provider Active NPI

Sanjay Yathiraj, MD

  • Neurology Physician
  • Bradenton, FL
National Provider Identifier
1508851718
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME72170 Issued in FL
Practice address
2902 59TH St W Ste D
Bradenton, FL 34209-7021
Phone
(941) 877-7007
Fax
(941) 238-9119
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME72170 FL Primary

Addresses

Primary practice location

2902 59TH St W Ste D
Bradenton, FL 34209-7021

Mailing address

PO Box 14675
Bradenton, FL 34280-4675
Phone (941) 877-7007

Other practice location 1

7005 Cortez Rd W
Bradenton, FL 34210
Phone (941) 750-0602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040320000049 FL Practitioner - NeurologyPractitioner - Sleep Medicine 4981595006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Sleep Medicine
Education
Wright State University Boonshoft School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palma Sola Neurology AssociatesGroup PAC ID 8527328947, 4 clinicians

Practice addresses (Care Compare)

2902 59TH Steet W
Suite D
Bradenton, FL 34209-7021
Phone (941) 877-7007

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy118

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Palma Sola Neurology Associates Neurology CurrentSince Nov 6, 2017 Accepting new patients
Pinnacle Physician Network, LLC Past Accepting new patients
Pinnacle Medical Group PA Neurology Past Accepting new patients

Locations

2902 59th St W
Ste D
Bradenton, FL 34209
Phone (941) 877-7007

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IIDBBD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1508851718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14675",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342804675",
            "telephone_number": "941-877-7007",
            "fax_number": "941-238-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 59TH ST W STE D",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097021",
            "telephone_number": "941-877-7007",
            "fax_number": "941-238-9119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7005 Cortez Rd W",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "34210",
            "country_code": "US",
            "telephone_number": "941-750-0602",
            "fax_number": "941-748-5626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YATHIRAJ",
        "first_name": "SANJAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME72170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.