NPIMap

Individual provider Active NPI

Latha Pandurangan, M.D.

  • Family Medicine Physician
  • Dunedin, FL
National Provider Identifier
1720387244
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME117760 Issued in FL
Practice address
180 Patricia Ave
Dunedin, FL 34698-8103
Phone
(727) 733-4193
Fax
(813) 635-2638
NPI assigned
Mar 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 ME117760 FL Primary

Addresses

Primary practice location

180 Patricia Ave
Dunedin, FL 34698-8103

Mailing address

180 Patricia Ave
Dunedin, FL 34698-8103
Phone (727) 733-4193

Other identifiers 2

IdentifierTypeStateIssuer
P01375021OtherFLMEDICARE RAILROAD PROVIDER NUMBER
012839400MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Latha.Pandurangan@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

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
I20140916000691 FL Practitioner - Family Practice 0749409241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

2931 Alt
Suite 19
Palm Harbor, FL 34683-1928
Phone (727) 785-2298

2939 Alt
Suite 19
Palm Harbor, FL 34683-1928
Phone (727) 785-2298

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME117760FLMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: latha.pandurangan@direct.mybaycare.org

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720387244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PATRICIA AVE",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346988103",
            "telephone_number": "727-733-4193",
            "fax_number": "813-635-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PATRICIA AVE",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346988103",
            "telephone_number": "727-733-4193",
            "fax_number": "813-635-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDURANGAN",
        "first_name": "LATHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME117760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PROVIDER NUMBER",
            "identifier": "P01375021",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012839400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Latha.Pandurangan@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew St Fl 2",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337593012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dunedin, FL

Sources for this page

Verify at the official NPI Registry.