Individual provider Active NPI

Kalyani R Meduri, M.D.

  • Gastroenterology Physician
  • Zephyrhills, FL
National Provider Identifier
1558513168
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME141486 Issued in FL
Practice address
6340 Fort King Rd
Zephyrhills, FL 33542-2531
Phone
(813) 782-6116
Fax
(813) 780-1015
NPI assigned
Oct 14, 2008
Last updated
May 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME141486 FL
Internal Medicine Physician 207R00000X 036121876 IL
Internal Medicine Physician 207R00000X 39329 IA
Gastroenterology Physician 207RG0100X MD456022 PA
Gastroenterology Physician 207RG0100X ME141486 FL Primary

Addresses

Primary practice location

6340 Fort King Rd
Zephyrhills, FL 33542-2531

Mailing address

6340 Fort King Rd
Zephyrhills, FL 33542-2531
Phone (813) 782-6116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150921002667 PA Practitioner - GastroenterologyPractitioner - Internal Medicine 6406032051 Reassigns benefits to 1 organization
I20210507001777 FL Practitioner - Gastroenterology 6406032051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

38240 Daughtery Rd
Zephyrhills, FL 33540-1367
Phone (813) 788-3582

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy22
Upper gastrointestinal (GI) endoscopy for acid reflux65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME141486FLMDInternal Medicine Physician
39329IAMDInternal Medicine Physician
036121876ILMDInternal Medicine Physician
MD456022PAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Physician Network LLC Internal Medicine CurrentSince Oct 19, 2015 Accepting new patients
Florida Hospital Physician Group Inc Internal Medicine CurrentSince Mar 29, 2021 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

38240 Daughtery Rd
Zephyrhills, FL 33540
Phone (813) 788-3582

6340 Fort King Rd
Zephyrhills, FL 33542
Phone (813) 782-6116

610 Wyoming Ave
Kingston, PA 18704
Phone (570) 288-5441

4 E Main St
Nanticoke, PA 18634
Phone (570) 258-3939

545 N River St
Ste 100
Wilkes Barre, PA 18702
Phone (570) 208-8800

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kmeduri73891@adventhealth.direct-ci.com

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 4

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": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1558513168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6340 FORT KING RD",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335422531",
            "telephone_number": "813-782-6116",
            "fax_number": "813-780-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6340 FORT KING RD",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335422531",
            "telephone_number": "813-782-6116",
            "fax_number": "813-780-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDURI",
        "first_name": "KALYANI",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-14",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME141486",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036121876",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "39329",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD456022",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME141486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.