Individual provider Active NPI

Sanjeev Bhatta, M.D.

  • Interventional Cardiology Physician
  • Leesburg, FL
National Provider Identifier
1770576100
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME82971 Issued in FL
Practice address
803 E Dixie Ave
Leesburg, FL 34748-6013
Phone
(352) 530-2256
Fax
(352) 414-4638
NPI assigned
Aug 31, 2005
Last updated
Apr 1, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME 82971 FL
Interventional Cardiology Physician 207RI0011X ME82971 FL Primary
Nuclear Cardiology Physician 207UN0901X ME 82971 FL

Addresses

Primary practice location

803 E Dixie Ave
Leesburg, FL 34748-6013

Mailing address

803 E Dixie Ave
Leesburg, FL 34748-6013
Phone (352) 530-2256

Other identifiers 2

IdentifierTypeStateIssuer
09012OtherFLBCBS
263891600MedicaidFL

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
I20100813000792 FL Practitioner - Cardiovascular Disease (Cardiology) 9335273234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiothoracic and Vascular Surgical Associates PAGroup PAC ID 5395725188, 85 clinicians

Practice addresses (Care Compare)

1032 Mar Walt Dr
Unit 250
Fort Walton Beach, FL 32547-6663
Phone (850) 682-0032

1824 King St
Suite 200
Jacksonville, FL 32204-4736
Phone (904) 384-3343

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Leg revascularization (restoring blood flow)12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 82971FLMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiothoracic & Vascular Surgical Associates PA Cardiovascular Disease CurrentSince Dec 1, 2022 Accepting new patients
Neuropsychiatry Centers LLC PastSince Sep 1, 2016 Accepting new patients

Locations

1032 Mar Walt Dr
Unit 250
Ft Walton Bch, FL 32547
Phone (850) 682-0032

1824 King St
Ste 200
Jacksonville, FL 32204
Phone (904) 384-3343

801 E Dixie Ave
Ste 107
Leesburg, FL 34748
Phone (352) 315-0627

803 E Dixie Ave
Leesburg, FL 34748
Phone (352) 530-2256

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: sbhatta562452@direct.shands.ufl.edu

Organizations & group practices 3

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 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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1770576100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347486013",
            "telephone_number": "352-530-2256",
            "fax_number": "352-414-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347486013",
            "telephone_number": "352-530-2256",
            "fax_number": "352-414-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATTA",
        "first_name": "SANJEEV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME 82971",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME82971",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "FL",
            "license": "ME 82971",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09012",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263891600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.