NPIMap

Individual provider Active NPI

Sujatha Baskar, MD

  • Internal Medicine Physician
  • Tavares, FL
National Provider Identifier
1699764910
Registry record updated May 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME94000 Issued in FL
Practice address
1866 Mayo Dr
Tavares, FL 32778-4320
Phone
(352) 508-5171
Fax
(352) 508-5275
NPI assigned
Oct 19, 2005
Last updated
May 27, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2015

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 ME94000 FL Primary

Addresses

Primary practice location

1866 Mayo Dr
Tavares, FL 32778-4320

Mailing address

1866 Mayo Dr
Tavares, FL 32778-4320
Phone (352) 508-5171

Other identifiers 1

IdentifierTypeStateIssuer
27401500MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051205000432 FL Practitioner - Internal Medicine 9638199763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1866 Mayo Dr
Tavares, FL 32778-4320
Phone (352) 508-5171

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Primary Medical Care LLC Internal Medicine CurrentSince Sep 1, 2005 Accepting new patients

Locations

1866 Mayo Dr
Tavares, FL 32778
Phone (352) 357-0880

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1699764910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1866 MAYO DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784320",
            "telephone_number": "352-508-5171",
            "fax_number": "352-508-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 MAYO DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784320",
            "telephone_number": "352-508-5171",
            "fax_number": "352-508-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASKAR",
        "first_name": "SUJATHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME94000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27401500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.