Sampath Kumar Manickam, M.D.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

ME133234 Issued in FL

Practice address

8383 S Tamiami TRL Unit 115
Sarasota, FL 34238-2901

Phone

(941) 497-4069

Fax

(941) 496-9475

NPI assigned

Jun 14, 2012

Last updated

Jan 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Rheumatology

Education

University of Miami, LM Miller School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Empath Therapies LLCGroup PAC ID 5496144529, 108 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
• Sarasota Memorial Hospital - Venice Hospital, North Venice, FL, CCN 100359

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: sampath.manickam.1@4290.direct.athenahealth.com

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.

• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Empath Therapies, LLC

  • Health Service Clinic/Center
  • Venice, FL
  • NPI 1346912805
  Care Compare group
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702

  Multi-Specialty

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sarasota County Public Hospital District

  dba Sarasota Memorial Hospital - Venice

  • General Acute Care Hospital
  • North Venice, FL
  • NPI 1013534445
  Care Compare affiliation
• Sarasota County Public Hospital District

  dba Sarasota Memorial Hospital

  • General Acute Care Hospital
  • Sarasota, FL
  • NPI 1245294826
  Care Compare affiliation

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1770845711",
    "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",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8383 S TAMIAMI TRL UNIT 115",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342382901",
            "telephone_number": "941-497-4069",
            "fax_number": "941-496-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANICKAM",
        "first_name": "SAMPATH",
        "middle_name": "KUMAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "FL",
            "license": "ME133234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sampath.manickam.1@4692.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "8383 S Tamiami Trl Unit 115",
            "city": "Sarasota",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342382901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shawn Jared Mandel, PSY.D.
• Cindy Mang
• Manu Achyut Mangalvedkar
• Janine Mangini, M.D.
• Mangrove Mental Health LLC
• Gnanambal Manivel, M.D
• David Brian Mankowitz, D.C.
• Kristin Manley, PHARMD
• John Ned Mann, MSW LCSW
• Sheldon R Mann, DDS

• Rheumatology Physician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Rheumatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.