Individual provider Active NPI

Roja Chandrashekhar Pondicherry-Harish, M.D.

  • Interventional Cardiology Physician
  • Gainesville, FL
National Provider Identifier
1669764437
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME136583 Issued in FL
Practice address
4645 NW 8TH Ave
Gainesville, FL 32605
Phone
(352) 375-1212
Fax
(352) 371-4650
NPI assigned
May 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TRN16036 FL
Cardiovascular Disease Physician 207RC0000X ME136583 FL
Interventional Cardiology Physician 207RI0011X ME136583 FL Primary

Addresses

Primary practice location

4645 NW 8TH Ave
Gainesville, FL 32605

Mailing address

4645 NW 8TH Ave
Gainesville, FL 32605-4524
Phone (352) 375-1212

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
I20180822003653 FL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 3678715232 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Medical College of Georgia School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Interventional Cardiologists of Gainesville, PAGroup PAC ID 8820077241, 36 clinicians

Practice addresses (Care Compare)

4645 NW 8TH Ave
Suite 20
Gainesville, FL 32605-4688
Phone (352) 375-1212

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting39
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac and Vascular Institute Ambulatory Surgery Center, LLC Cardiovascular Disease CurrentSince Jun 3, 2021 Accepting new patients
Interventional Cardiologists of Gainesville, PA Cardiovascular Disease CurrentSince Aug 1, 2018 Accepting new patients

Locations

4645 NW 8th Ave
Ste 20
Gainesville, FL 32605
Phone (352) 375-1212

1151 NW 64th Ter
Gainesville, FL 32605
Phone (352) 331-8570

4645 NW 8th Ave
Ste 10
Gainesville, FL 32605
Phone (352) 375-1212

4645 NW 8th Ave
Gainesville, FL 32605
Phone (352) 264-2500

3239 NW York Dr
Lake City, FL 32055
Phone (352) 375-1212

Organizations & group practices 2

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 2

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": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1669764437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 NW 8TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054524",
            "telephone_number": "352-375-1212",
            "fax_number": "352-371-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 NW 8TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-375-1212",
            "fax_number": "352-371-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDICHERRY-HARISH",
        "first_name": "ROJA",
        "middle_name": "CHANDRASHEKHAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-11",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN16036",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME136583",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME136583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.