Individual provider Active NPI

Ganesh Athappan, MD

  • Interventional Cardiology Physician
  • Port Charlotte, FL
National Provider Identifier
1770749392
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME133681 Issued in FL
Practice address
3340 Tamiami TRL
Port Charlotte, FL 33952-8088
Phone
(941) 764-5858
Fax
(941) 764-1657
NPI assigned
Aug 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 235682 MA
Interventional Cardiology Physician 207RI0011X ME133681 FL Primary

Addresses

Primary practice location

3340 Tamiami TRL
Port Charlotte, FL 33952-8088

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171004001422 FL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3476780925 Reassigns benefits to 1 organization
I20190206000007 PA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 3476780925 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

3340 Tamiami TRL
Port Charlotte, FL 33952-8088
Phone (941) 237-7100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting34
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
235682MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC Current Accepting new patients
Millennium Physician Group LLC Internal Medicine CurrentSince Mar 1, 2025 Accepting new patients
DLP Conemaugh Physician Practices LLC Internal Medicine CurrentSince Jan 9, 2019 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Millennium Physician Group LLC CurrentSince Mar 1, 2025 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Jan 9, 2019 Accepting new patients
Wellspan Medical Group CurrentSince Jan 6, 2020 Accepting new patients
St Lucie Medical Specialists LLC Internal Medicine PastSince Apr 1, 2020 Accepting new patients
Thoracic & Cardiovascular Surgeons LLC Past Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

3340 Tamiami Trl
Pt Charlotte, FL 33952
Phone (941) 764-5858

2227 US Highway 27 S
Ste 101
Sebring, FL 33870
Phone (863) 385-4300

446 N Reading Rd
Ste 301
Ephrata, PA 17522
Phone (717) 733-6546

446 N Reading Rd
Ste 302
Ephrata, PA 17522
Phone (717) 721-5868

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1 Tech Park Dr
Johnstown, PA 15901
Phone (814) 475-8600

140 N Pointe Blvd
Lancaster, PA 17601
Phone (717) 291-0700

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: ganesh.athappan.1@4290.direct.athenahealth.com
  • Direct secure messaging: athappan@bradentoncardiology.gwaydirect.com

Organizations & group practices 9

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": "1217721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1770749392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528088",
            "telephone_number": "941-764-5858",
            "fax_number": "941-764-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHAPPAN",
        "first_name": "GANESH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-03",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "235682",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME133681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.