Organization Active NPI

Apollo Medical Group PA

  • Internal Medicine Physician
  • Trinity, FL
National Provider Identifier
1619167111
Registry record updated Nov 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
APOLLO MEDICAL GROUP PA
Practice address
3535 Little Road
Trinity, FL 34655-1811
Phone
(727) 375-0848
Fax
(727) 375-5548
NPI assigned
Jul 31, 2007
Last updated
Nov 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2013

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

Authorized official

Name
Jayadeva Chowdappa, MDNPI 1609871805
Title
President
Phone
(727) 375-0848

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)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

3535 Little Road
Trinity, FL 34655-1811

Mailing address

3535 Little Road
Trinity, FL 34655-1811
Phone (727) 375-0848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080303000526 FL Part B Supplier - Clinic/Group Practice 6103900931 Receives reassigned benefits from 13 practitioners
Practice locations: Bradenton, FL; Clearwater, FL; Tampa, FL; Trinity, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2298157Apollo Medical Group PA3535 Little Rd, Trinity, FL 34655Certificate of waiverJan 29, 2028

National Provider Directory

National Provider Directory

Locations

3535 Little Rd
Trinity, FL 34655
Phone (727) 375-0848

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GJGABA

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385337600000",
    "number": "1619167111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 LITTLE ROAD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551811",
            "telephone_number": "727-375-0848",
            "fax_number": "727-375-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 LITTLE ROAD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551811",
            "telephone_number": "727-375-0848",
            "fax_number": "727-375-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOLLO MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2013-11-25",
        "status": "A",
        "authorized_official_last_name": "CHOWDAPPA",
        "authorized_official_first_name": "JAYADEVA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-375-0848",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; 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.

Verify at the official NPI Registry.