Individual provider Active NPI

Paula Thulasi Charugundla, MD

  • Internal Medicine Physician
  • Largo, FL
National Provider Identifier
1588221972
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME157822 Issued in FL
Practice address
1301 2ND Ave SW
Largo, FL 33770-2298
Phone
(727) 584-7706
Fax
(727) 581-3727
NPI assigned
May 22, 2019
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME157822 FL Primary

Addresses

Primary practice location

1301 2ND Ave SW
Largo, FL 33770-2298

Mailing address

1301 2ND Ave SW
Largo, FL 33770-2298
Phone (727) 584-7706

Other identifiers 1

IdentifierTypeStateIssuer
GDSAJOtherFLFLORIDA BLUE

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220924000148 FL Practitioner - Internal Medicine 6507241783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Care Hospitalists PLGroup PAC ID 5092753632, 66 clinicians

Practice addresses (Care Compare)

4315 Highland Park Blvd
Suite D
Lakeland, FL 33813-1639
Phone (863) 816-5884

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME157822FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Care Hospitalists PL CurrentSince Oct 1, 2023 Accepting new patients

Locations

4315 Highland Park Blvd
Ste D
Lakeland, FL 33813
Phone (863) 816-5884

Organizations & group practices 1

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 1

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": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1588221972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 2ND AVE SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337702298",
            "telephone_number": "727-584-7706",
            "fax_number": "727-581-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 2ND AVE SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337702298",
            "telephone_number": "727-584-7706",
            "fax_number": "727-581-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARUGUNDLA",
        "first_name": "PAULA",
        "middle_name": "THULASI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME157822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "GDSAJ",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.