NPIMap

Organization Active NPI

Korunda Medical, LLC

  • Interventional Pain Medicine Physician
  • Naples, FL
National Provider Identifier
1609056282
Registry record updated Sep 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
ME86588 Issued in FL
Legal business name
KORUNDA MEDICAL, LLC
Practice address
4513 Executive Dr
Naples, FL 34119-8884
Phone
(239) 591-2803
Fax
(239) 594-5637
NPI assigned
Nov 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2017

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

Authorized official

Name
Zdenko Korunda, M.D.NPI 1104876861
Title
Physician/Owner
Phone
(239) 591-2803

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X ME114039 FL
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X ME82233 FL
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X OS11178 FL
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X ME86588 FL Primary

Addresses

Primary practice location

4513 Executive Dr
Naples, FL 34119-8884

Mailing address

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

Other names 1

  • Korunda Pain Management Center Former legal business name

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
Practice locations: Bonita Springs, FL; Naples, FL
O20111019000267 FL DME Supplier - Physician - General Practice 5092895334 Practice locations: Naples, 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.

National Provider Directory

National Provider Directory

Locations

4513 Executive Dr
Naples, FL 34119
Phone (239) 431-6464

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504224000000",
    "number": "1609056282",
    "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": "4513 EXECUTIVE DR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341198884",
            "telephone_number": "239-591-2803",
            "fax_number": "239-594-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KORUNDA MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-12",
        "last_updated": "2017-09-01",
        "status": "A",
        "authorized_official_last_name": "KORUNDA",
        "authorized_official_first_name": "ZDENKO",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "239-591-2803",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME114039",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME82233",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "OS11178",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME86588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Korunda Pain Management Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.