Individual provider Active NPI

Sandeep Naresh Chugani, DO

  • Family Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1659831253
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS18312 Issued in FL
Practice address
2812 54TH Ave S
St Petersburg, FL 33712-4610
Phone
(727) 867-8641
Fax
(727) 867-6795
NPI assigned
Mar 21, 2019
Last updated
Jul 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X FL
Family Medicine Physician 207Q00000X OS18312 FL Primary

Addresses

Primary practice location

2812 54TH Ave S
St Petersburg, FL 33712-4610

Mailing address

5130 Sunforest Dr Ste 300
Tampa, FL 33634-6327
Phone (727) 824-0780

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
I20220705000763 FL Practitioner - Family Practice 6204216500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

2812 54TH Ave S
Optum Bayway
Saint Petersburg, FL 33712-4610
Phone (727) 867-8641

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida LLC Family Medicine CurrentSince Jul 17, 2022 Accepting new patients
Optumcare Florida, LLC CurrentSince Aug 15, 2022 Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients

Locations

1989 W Lumsden Rd
Brandon, FL 33511
Phone (813) 653-3111

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

2812 54th Ave S
St Petersburg, FL 33712
Phone (727) 867-8641

5130 Sunforest Dr
Ste 300
Tampa, FL 33634
Phone (813) 302-5835

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: sandeep.chugani@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1659831253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 SUNFOREST DR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346327",
            "telephone_number": "727-824-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 54TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337124610",
            "telephone_number": "727-867-8641",
            "fax_number": "727-867-6795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUGANI",
        "first_name": "SANDEEP",
        "middle_name": "NARESH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS18312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.