Active NPI
Manatee Gynecology LLC
- Gynecology Physician
- Bradenton, FL
National Provider Identifier
1578077970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- Legal business name
- MANATEE GYNECOLOGY LLC
- Practice address
- 2310 60TH Street CT W
Bradenton, FL 34209-6609 - Phone
- (941) 792-4993
- NPI assigned
- Nov 21, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kinnari Desai, MD
- Title
- Owner
- Phone
- (941) 792-4993
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | Primary |
Addresses
Primary practice location
2310 60TH Street CT W
Bradenton, FL 34209-6609
Mailing address
2310 60TH Street CT W
Bradenton, FL 34209-6609
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180504001820 | FL | Part B Supplier - Clinic/Group Practice | 5496019119 |
Receives reassigned benefits from 16 practitioners Practice locations: Bradenton, FL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2144788 | Manatee Gynecology LLC | Provider-performed microscopy | Jul 22, 2027 |
National Provider Directory
National Provider DirectoryInteroperability endpoints
- https://fhir4.healow.com/fhir/r4/GBBCBD
Practitioners & affiliated clinicians
Practitioners 17
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
- New Port Richey, FL
- NPI 1346534948
FL
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511222400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1512604800000",
"number": "1578077970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2310 60TH STREET CT W",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342096609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 60TH STREET CT W",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342096609",
"telephone_number": "941-792-4993"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MANATEE GYNECOLOGY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-11-21",
"last_updated": "2017-12-07",
"status": "A",
"authorized_official_last_name": "DESAI",
"authorized_official_first_name": "KINNARI",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "941-792-4993",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2017; 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.