Individual provider Active NPI

Sambasiva K. Rao Musunuru, M.D.

  • Interventional Cardiology Physician
  • Hudson, FL
National Provider Identifier
1679576805
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME 37395 Issued in FL
Practice address
14100 Fivay Rd
Hudson, FL 34667-7180
Phone
(727) 862-1080
Fax
(727) 863-3093
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X ME 37395 FL Primary

Addresses

Primary practice location

14100 Fivay Rd
Hudson, FL 34667-7180

Mailing address

14100 Fivay Rd
Ste 160
Hudson, FL 34667-7194
Phone (727) 862-1080

Other identifiers 1

IdentifierTypeStateIssuer
252929700MedicaidFL

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
I20100513001061 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9335277565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayonet Point/Hudson Cardiology AssociatesGroup PAC ID 7618005836, 4 clinicians

Practice addresses (Care Compare)

14100 Fivay Rd
Suite 160
Hudson, FL 34667-7194
Phone (727) 862-1080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 37395FLMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayonet Point/Hudson Cardiology Associates Interventional Cardiology CurrentSince Sep 22, 1980 Accepting new patients

Locations

14100 Fivay Rd
Ste 160
Hudson, FL 34667
Phone (727) 862-1080

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1679576805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 FIVAY RD",
            "address_2": "STE 160",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677194",
            "telephone_number": "727-862-1080",
            "fax_number": "727-863-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 FIVAY RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677180",
            "telephone_number": "727-862-1080",
            "fax_number": "727-863-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSUNURU",
        "first_name": "SAMBASIVA",
        "middle_name": "K. RAO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME 37395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252929700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

Verify at the official NPI Registry.