Individual provider Active NPI

Sanjay Kumar, MD

  • Internal Medicine Physician
  • Port Charlotte, FL
National Provider Identifier
1669585378
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME79391 Issued in FL
Practice address
2343 Aaron St
Port Charlotte, FL 33952-5305
Phone
(941) 629-2900
Fax
(855) 808-2036
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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 ME79391 FL Primary

Addresses

Primary practice location

2343 Aaron St
Port Charlotte, FL 33952-5305

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other identifiers 2

IdentifierTypeStateIssuer
260040400MedicaidFL
35876OtherFLBCBS

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
I20050526000166 FL Practitioner - Internal Medicine 2961444229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1940 Tamiami TRL
Suite 104
Port Charlotte, FL 33948-2105
Phone (941) 883-0083

2315 Aaron St
Port Charlotte, FL 33952-5305
Phone (941) 613-2222

Hospital & facility affiliations

  • Millennium Home Care LLC Home health agency, Port Charlotte, FL, CCN 109401

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME79391FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince May 1, 2010 Accepting new patients
Millennium Physician Group LLC Internal Medicine CurrentSince May 1, 2010 Accepting new patients
Gulf Coast Hma Physician Management LLC Past Accepting new patients
Port Charlotte Hma Physician Management LLC Internal Medicine Past Accepting new patients
Port Charlotte Hma Physician Management LLC Past Accepting new patients
Gulf Coast Hma Physician Management LLC Internal Medicine Past Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

3434 Hancock Bridge Pkwy
North Ft Myers, FL 33903

2315 Aaron St
Port Charlotte, FL 33952
Phone (941) 613-2222

2343 Aaron St
Pt Charlotte, FL 33952
Phone (855) 979-5700

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

25097 Olympia Ave
Ste 102
Punta Gorda, FL 33950
Phone (941) 237-7100

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: sanjay.kumar.15@4290.direct.athenahealth.com

Organizations & group practices 6

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.

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1669585378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2343 AARON ST",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525305",
            "telephone_number": "941-629-2900",
            "fax_number": "855-808-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "SANJAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME79391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260040400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35876",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.