Individual provider Active NPI

Trishanna Crystal Sookdeo, M.D.

  • Family Medicine Physician
  • Winter Garden, FL
National Provider Identifier
1700172210
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME125389 Issued in FL
Practice address
14101 W Colonial Dr
Winter Garden, FL 34787-4206
Phone
(407) 395-2004
Fax
(407) 395-2005
NPI assigned
Jun 22, 2011
Last updated
Feb 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME125389 FL Primary

Addresses

Primary practice location

14101 W Colonial Dr
Winter Garden, FL 34787-4206

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (407) 395-2004

Other practice location 1

410 Lionel Way
3rd Floor
Davenport, FL 33837-7809
Phone (863) 419-2420

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGOtherFLMEDICARE

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
I20151208002111 FL Practitioner - Family Practice 9133429525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians

Practice addresses (Care Compare)

140 6TH Ave
Indialantic, FL 32903-3204
Phone (321) 312-3501

14101 W Colonial Dr
Winter Garden, FL 34787-4206
Phone (770) 312-5226

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME125389FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Privia Medical Group Florida, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

410 Lionel Way
Fl 3
Davenport, FL 33837
Phone (863) 419-2420

140 6th Ave
Indialantic, FL 32903
Phone (321) 312-3501

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958
Phone (727) 617-1777

14101 W Colonial Dr
Winter Garden, FL 34787
Phone (407) 395-2004

Interoperability endpoints

  • Direct secure messaging: trishanna.sookdeo.1@8042.direct.athenahealth.com

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

Hospital & facility affiliations 4

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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1700172210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "407-395-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14101 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874206",
            "telephone_number": "407-395-2004",
            "fax_number": "407-395-2005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 Lionel Way",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "FL",
            "postal_code": "338377809",
            "country_code": "US",
            "telephone_number": "863-419-2420",
            "fax_number": "863-419-2429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOOKDEO",
        "first_name": "TRISHANNA",
        "middle_name": "CRYSTAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME125389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.