Prem Srinivas Subramaniyam, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

ME165319 Issued in FL

Practice address

410 Lionel Way Ste 201
Davenport, FL 33837-7809

Phone

(863) 422-5331

NPI assigned

Sep 28, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional Cardiology

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Heart of Florida Hospital, Davenport, FL, CCN 100137
• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
• Adventhealth Lake Wales Hospital, Lake Wales, FL, CCN 100099

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as group

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: psubramaniyam2230438@adventhealth.direct-ci.com

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.

• Florida Hospital Physician Group Inc

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256

  Internal Medicine

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventhealth Polk North Inc

  • General Acute Care Hospital
  • Davenport, FL
  • NPI 1801457510
  Care Compare affiliation
• Adventhealth Polk South Inc

  • General Acute Care Hospital
  • Lake Wales, FL
  • NPI 1053972760
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1578872487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 LIONEL WAY STE 201",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338377809",
            "telephone_number": "863-422-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 LIONEL WAY STE 201",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338377809",
            "telephone_number": "863-422-5331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Trillium Way Ste 210",
            "address_purpose": "LOCATION",
            "city": "Corbin",
            "state": "KY",
            "postal_code": "407018490",
            "country_code": "US",
            "telephone_number": "606-523-3038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUBRAMANIYAM",
        "first_name": "PREM SRINIVAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-28",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "254528",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": "TP441",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME165319",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10036946",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "psubramaniyam75473@bhkydirect.com",
            "affiliation": "N",
            "address_1": "2 Trillium Way Ste 210",
            "city": "Corbin",
            "state": "KY",
            "country_code": "US",
            "postal_code": "407018490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Synnamon Alyse Stone, BT
• Kenneth J Stroub, D.O.
• Tracena Annette Studmire, HOME HEALTH
• William Stupelis
• Alexis Francisco Suarez, APRN
• Suma & Durga PA
• Sun Health and Wellness, Inc
• Sun Health and Wellness, Inc
• Sun Healthcare Consultants, LLC
• Sun Life Chiropractic and Injury Center LLC

• Interventional Cardiology Physician in Davenport, FL
• Providers in Davenport, FL by specialty
• Interventional Cardiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.

Verify at the official NPI Registry.