NPIMap

Individual provider Active NPI

Preeti Harchandani, MD

  • Internal Medicine Physician
  • Lake Wales, FL
National Provider Identifier
1770503252
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME85714 Issued in FL
Practice address
405 S 11TH St
Lake Wales, FL 33853-4202
Phone
(863) 679-8000
Fax
(863) 679-8008
NPI assigned
Jul 20, 2006
Last updated
Dec 20, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME85714 FL Primary

Addresses

Primary practice location

405 S 11TH St
Lake Wales, FL 33853-4202

Mailing address

4312 Duck Down LN
Winter Haven, FL 33884-3293
Phone (863) 679-8000

Other identifiers 1

IdentifierTypeStateIssuer
51547OtherFLBLUE CROSS BLUE SHIELD

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
I20111220000231 FL Practitioner - Internal Medicine 7012183106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Medical Specialists LLCGroup PAC ID 5799786687, 125 clinicians

Practice addresses (Care Compare)

2209 N Blvd W
Ridge Medical Associates
Davenport, FL 33837-8903
Phone (863) 679-8000

3830 Bee Ridge Rd
Sarasota, FL 34233-1105

405 S 11TH St
Ridge Medical Associates
Lake Wales, FL 33853-4202
Phone (863) 679-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Specialists LLC Current Accepting new patients
Florida Medical Specialists LLC CurrentSince May 29, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Best Value Healthcare LLC Internal Medicine Past Accepting new patients

Locations

2209 North Blvd W
Davenport, FL 33837
Phone (863) 679-8000

2209 North Blvd W
Ste A
Davenport, FL 33837
Phone (863) 679-8000

405 S 11th St
Lake Wales, FL 33853
Phone (863) 676-6363

3830 Bee Ridge Rd
Ste 100
Sarasota, FL 34233
Phone (941) 921-0383

3830 Bee Ridge Rd
Ste 301
Sarasota, FL 34233
Phone (941) 923-1872

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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 6

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1770503252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4312 DUCK DOWN LN",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843293",
            "telephone_number": "863-679-8000",
            "fax_number": "863-679-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S 11TH ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534202",
            "telephone_number": "863-679-8000",
            "fax_number": "863-679-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARCHANDANI",
        "first_name": "PREETI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME85714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51547",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

Verify at the official NPI Registry.