NPIMap

Organization Active NPI

Korunda Medical, LLC

Doing business as Korunda Medical Institute

  • Interventional Pain Medicine Physician
  • Bonita Springs, FL
National Provider Identifier
1548788292
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
ME124754 Issued in FL
Legal business name
KORUNDA MEDICAL, LLC
Doing business as
Korunda Medical Institute
Korunda Pain Management Center
Practice address
26741 Dublin Woods Cir
Bonita Springs, FL 34135-7272
Phone
(239) 591-2803
Fax
(239) 594-5637
NPI assigned
Sep 1, 2017
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
KORUNDA MEDICAL, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Zdenko Korunda, MDNPI 1104876861
Title
Medical Director
Phone
(239) 591-2803

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
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X ME124754 FL Primary

Addresses

Primary practice location

26741 Dublin Woods Cir
Bonita Springs, FL 34135-7272

Mailing address

PO Box 110820
Naples, FL 34108-0114
Phone (239) 591-2803

Other names 2

  • Korunda Medical Institute Doing business as
  • Korunda Pain Management Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071228000056 FL Part B Supplier - Clinic/Group Practice 5092895334 Receives reassigned benefits from 21 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bonita Springs, FL; Naples, FL
O20180208003128 FL DME Supplier - Physician - General Practice 5092895334 Practice locations: Bonita Springs, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
10D1107462Korunda Medical LLC26741 Dublin Woods Cir, Bonita Springs, FL 34135Certificate of waiverNov 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Korunda Medical LLC2 organizations share this tax ID, including this one
Part of
Korunda Medical LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

26741 Dublin Woods Cir
Bonita Springs, FL 34135
Phone (239) 449-7979

Practitioners & affiliated clinicians

Practitioners 5

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": "1504224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1548788292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110820",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341080114",
            "telephone_number": "239-591-2803",
            "fax_number": "239-594-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26741 DUBLIN WOODS CIR",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341357272",
            "telephone_number": "239-591-2803",
            "fax_number": "239-594-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KORUNDA MEDICAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KORUNDA MEDICAL, LLC",
        "enumeration_date": "2017-09-01",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "KORUNDA",
        "authorized_official_first_name": "ZDENKO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "239-591-2803",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME124754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Korunda Medical Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Korunda Pain Management Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.