NPIMap

Individual provider Active NPI

George S Muthalakuzhy, MD

  • Nephrology Physician
  • Zephyrhills, FL
National Provider Identifier
1689769044
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME104902 Issued in FL
Practice address
5344 9TH St Ste 107
Zephyrhills, FL 33542-4348
Phone
(813) 724-3868
Fax
(813) 724-3992
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME104902 FL
Nephrology Physician 207RN0300X ME104902 FL Primary
Internal Medicine Physician 207R00000X ME 104902 FL

Addresses

Primary practice location

5344 9TH St Ste 107
Zephyrhills, FL 33542-4348

Mailing address

PO Box 2619
Zephyrhills, FL 33539-2619
Phone (813) 724-3868

Other practice location 1

14502 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2040
Phone (813) 724-3868

Other identifiers 2

IdentifierTypeStateIssuer
001356600MedicaidFL
P01004046OtherFLMEDICARE RAILROAD PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091014000666 FL Practitioner - NephrologyPractitioner - Internal Medicine 6901902865 Reassigns benefits to 1 organization
I20180219000515 WV Practitioner - Internal Medicine 6901902865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14502 N Dale Mabry Hwy
Suite 200
Tampa, FL 33618-2040
Phone (813) 724-3868

5344 9TH St
Suite 107
Zephyrhills, FL 33542-4348
Phone (813) 724-3868

Hospital & facility affiliations

  • Usrc North Tampa Dialysis Dialysis facility, Tampa, FL, CCN 682587
  • DaVita Land O Lakes Dialysis Dialysis facility, Land O Lakes, FL, CCN 682598
  • DaVita Wesley Chapel Dialysis Dialysis facility, Wesley Chapel, FL, CCN 102887
  • Baycare Home Care Inc Home health agency, Tampa, FL, CCN 107285
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127
  • Morton Plant North Bay Hospital Hospital, New Port Richey, FL, CCN 100063
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
  • Adventhealth Wesley Chapel Hospital, Wesley Chapel, FL, CCN 100319
  • Adventhealth Connerton Long-term care hospital, Land O Lakes, FL, CCN 102026

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 104902FLMDInternal Medicine Physician
ME104902FLMDNephrology Physician

Practice roles (4 of 6)

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of West Virginia, PLLC Internal Medicine CurrentSince Sep 6, 2017 Accepting new patients
Hypertension Kidney and Stone Center, LLC Nephrology CurrentSince Oct 12, 2016 Accepting new patients
Elias Kanaan MD PA Internal Medicine PastSince Aug 20, 2001 Accepting new patients
Memorial Hermann Neighborhood Health Centers, PLLC Internal Medicine Past Accepting new patients

Locations

14502 N Dale Mabry Hwy
Ste 200
Tampa, FL 33618
Phone (813) 724-3868

12811 N Nebraska Ave
Ste I
Tampa, FL 33612

5344 9th St
Ste 107
Zephyrhills, FL 33542
Phone (813) 724-3868

2500 Hospital Dr
Martinsburg, WV 25401
Phone (304) 233-4134

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

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

Organizations & group practices 4

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 12

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1689769044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2619",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335392619",
            "telephone_number": "813-724-3868",
            "fax_number": "813-724-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5344 9TH ST STE 107",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335424348",
            "telephone_number": "813-724-3868",
            "fax_number": "813-724-3992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14502 N Dale Mabry Hwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336182040",
            "country_code": "US",
            "telephone_number": "813-724-3868",
            "fax_number": "813-724-3992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUTHALAKUZHY",
        "first_name": "GEORGE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME104902",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME104902",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 104902",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001356600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PROVIDER NUMBER",
            "identifier": "P01004046",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.