Individual provider Active NPI

Avinash Krishna Bhandary, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Mount Dora, FL
National Provider Identifier
1740465707
Registry record updated Feb 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
ME 114143 Issued in FL
Practice address
6909 Old Highway 441 S
Suite 104
Mount Dora, FL 32757-7039
Phone
(407) 605-5621
NPI assigned
Jan 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X ME 114143 FL Primary

Addresses

Primary practice location

6909 Old Highway 441 S
Suite 104
Mount Dora, FL 32757-7039

Mailing address

1502 N Donnelly St
Ste 107
Mount Dora, FL 32757-2846
Phone (407) 605-5621

Other identifiers 1

IdentifierTypeStateIssuer
14ME6OtherFLBCBS

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
I20121109000019 FL Practitioner - Physical Medicine and Rehabilitation 3971754441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1502 N Donnelly St
Suite 107
Mount Dora, FL 32757-2846
Phone (407) 605-5621

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 114143FLMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mana Medical Group LLC CurrentSince Feb 1, 2016 Accepting new patients
Comprehensive Health PLLC PastSince Jun 1, 2022 Accepting new patients

Locations

1502 N Donnelly St
Ste 107
Mount Dora, FL 32757
Phone (352) 383-8200

7984 Forest City Rd
Ste 104
Orlando, FL 32810
Phone (407) 605-5621

Interoperability endpoints

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518134400000",
    "number": "1740465707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 N DONNELLY ST",
            "address_2": "STE 107",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572846",
            "telephone_number": "407-605-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6909 OLD HIGHWAY 441 S",
            "address_2": "SUITE 104",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327577039",
            "telephone_number": "407-605-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHANDARY",
        "first_name": "AVINASH",
        "middle_name": "KRISHNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-08",
        "last_updated": "2018-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "ME 114143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14ME6",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

Verify at the official NPI Registry.