Srinivas Mutyala, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME0076746 Issued in FL

Practice address

2625 Executive Park Dr
Suite #4
Weston, FL 33331-3634

Phone

(954) 659-9051

Fax

(954) 659-9052

NPI assigned

Jan 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Ophthalmology

Education

University of Missouri, Kansas City, School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Weston Laser and Vision Institute, IncGroup PAC ID 9234282161, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mutyala.srinivas.005.0090209@wlvi.meditab.direct-ci.com

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.

• Weston Laser & Vision Institute, Inc

  • Ophthalmology Physician
  • Weston, FL
  • NPI 1568642676
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1689654717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 EXECUTIVE PARK DR",
            "address_2": "SUITE #4",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313634",
            "telephone_number": "954-659-9051",
            "fax_number": "954-659-9052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 EXECUTIVE PARK DR",
            "address_2": "SUITE #4",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313634",
            "telephone_number": "954-659-9051",
            "fax_number": "954-659-9052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTYALA",
        "first_name": "SRINIVAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0076746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254938700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Garfield A Munroe, M.D.
• Katherine L Murad, PA
• Andrew Murphy, MD
• Jordan Murphy, MD
• Nicolas A Muruve, M.D.
• My Developmental Therapy. Inc
• My Family Doc, LLC
• Myeyedr Optometry of Florida, LLC
• Katarzyna Naberezny, RDN
• Vineet Nadkarni

• Ophthalmology Physician in Weston, FL
• Providers in Weston, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.