Vijaya L Cherukuri, M.D.
Individual provider Active NPI Geriatric Medicine (Internal Medicine) Physician · Saint Petersburg, FL
NPI 1750375267 · NPPES record last updated May 18, 2015
Key facts
- NPI
- 1750375267
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician 207RG0300X
- License
- ME0076324 (FL)
- Practice address
- 218 Pasadena Ave S
Saint Petersburg, FL 33707-1251 - Phone
- (727) 345-0160
- Fax
- (727) 345-0100
- NPI assigned
- Sep 12, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Geriatric Medicine
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
218 Pasadena S Ave
Saint Petersburg, FL 33707-1251
Phone (727) 345-0160
9306 Silverthorn Rd
Largo, FL 33777-3163
Hospital & facility affiliations
- Pinnacle Home Care
- Trilogy Home Healthcare
- Hygeia Home Health LLC
- Centerwell Home Health
- Baycare Home Care Inc
- HCA Florida Pasadena Hospital a Part of HCA Florid
- HCA Florida St Petersburg Hospital
- HCA Florida Northside Hospital
- St Anthonys Hospital
- Morton Plant Hospital
- Springs at Boca Ciega Bay
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040403000078 | FL | Practitioner - Geriatric Medicine |
7113910555 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0076324 | FL | MD | Geriatric Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orlando Health, Inc. | Current | Accepting new patients | |
| Premier Health Care Inc | Current |
Accepting new patients | |
| American Family & Geriatric Care PA | Geriatric Medicine | Past | Accepting new patients |
| Elias Kanaan MD PA | Past |
Accepting new patients |
Locations
218 Pasadena Ave S
St Petersburg, FL 33707
Phone (727) 345-0160
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/ADDJAA
- vcherukuri189007@orlandohealth.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | ME0076324 | FL | Yes |
Addresses
Primary practice location
218 Pasadena Ave S
Saint Petersburg, FL 33707-1251
Mailing address
9306 Silverthorn Rd
Largo, FL 33777-3163
Phone (727) 345-0160
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 254803800 | Medicaid | FL |
NPI Registry JSON
{
"created_epoch": "1126483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431907200000",
"number": "1750375267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9306 SILVERTHORN RD",
"city": "LARGO",
"state": "FL",
"postal_code": "337773163",
"telephone_number": "727-345-0160",
"fax_number": "727-345-0100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 PASADENA AVE S",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337071251",
"telephone_number": "727-345-0160",
"fax_number": "727-345-0100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHERUKURI",
"first_name": "VIJAYA",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-12",
"last_updated": "2015-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "FL",
"license": "ME0076324",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "254803800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Petersburg, FL
- Angela Chen
- Damin Chen
- Li Chen
- Tiffany Chenneville
- Kari Cherry
- Myrtha L Chery
- Lisa Chester
- Amber M Chewning
- Angela Chiappone
- Casey Quentin Chiarello
All providers in Saint Petersburg, FL · Geriatric Medicine (Internal Medicine) Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.