Individual provider Active NPI

Prakash Goutham Beleyur Suryanarayana, MD

  • Clinical Cardiac Electrophysiology Physician
  • Clermont, FL
National Provider Identifier
1710174172
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
ME153140 Issued in FL
Practice address
2080 Oakley Seaver Dr Ste 130
Clermont, FL 34711-1962
Phone
(321) 841-6444
Fax
(407) 650-1307
NPI assigned
Oct 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X D88499 MD
Clinical Cardiac Electrophysiology Physician 207RC0001X ME153140 FL Primary

Addresses

Primary practice location

2080 Oakley Seaver Dr Ste 130
Clermont, FL 34711-1962

Mailing address

2080 Oakley Seaver Dr Ste 130
Clermont, FL 34711-1962
Phone (321) 841-6444

Other practice location 1

2800 E Ajo Way
Tucson, AZ 85713-6204
Phone (520) 874-3278

Other practice location 2

106 Milford St Ste 605
Salisbury, MD 21804-6938
Phone (347) 866-2011

Other identifiers 1

IdentifierTypeStateIssuer
113482600MedicaidFL

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
I20220222001938 FL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 9133362759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

2080 Oakley Seaver Dr
Ste. 120 and Ste. 130
Clermont, FL 34711-1962
Phone (321) 841-6444

Hospital & facility affiliations

  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Orlando Health-Health Central Hospital Hospital, Ocoee, FL, CCN 100030

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair47

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Cardiovascular Disease CurrentSince Mar 1, 2024 Accepting new patients
University of Florida Jacksonville Physicians Inc Cardiovascular Disease CurrentSince Feb 22, 2022 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Feb 22, 2022 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Family Medicine Current Accepting new patients

Locations

2080 Oakley Seaver Dr
Ste 120
Clermont, FL 34711

2080 Oakley Seaver Dr
Ste 130
Clermont, FL 34711
Phone (321) 844-6444

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 5

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 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": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1710174172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 OAKLEY SEAVER DR STE 130",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111962",
            "telephone_number": "321-841-6444",
            "fax_number": "407-650-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 OAKLEY SEAVER DR STE 130",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111962",
            "telephone_number": "321-841-6444",
            "fax_number": "407-650-1307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 E Ajo Way",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857136204",
            "country_code": "US",
            "telephone_number": "520-874-3278",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 Milford St Ste 605",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218046938",
            "country_code": "US",
            "telephone_number": "347-866-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURYANARAYANA",
        "first_name": "PRAKASH GOUTHAM",
        "middle_name": "BELEYUR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-01",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MD",
            "license": "D88499",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "FL",
            "license": "ME153140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113482600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.