Individual provider Active NPI

Mukti Pillappa, MD

  • Family Medicine Physician
  • Lake Mary, FL
National Provider Identifier
1801045760
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME102325 Issued in FL
Practice address
707 Platinum PT
Lake Mary, FL 32746-5702
Phone
(407) 878-0910
Fax
(407) 878-0911
NPI assigned
Sep 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME102325 FL Primary

Addresses

Primary practice location

707 Platinum PT
Lake Mary, FL 32746-5702

Mailing address

PO Box 9671
Daytona Beach, FL 32120-9671
Phone (386) 676-7130

Other identifiers 1

IdentifierTypeStateIssuer
003694300MedicaidFL

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
I20110630000229 FL Practitioner - Family Practice 5294893632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Health Care Plan IncGroup PAC ID 9436201233, 97 clinicians

Practice addresses (Care Compare)

707 Platinum PT
Lake Mary, FL 32746-5702
Phone (407) 878-0910

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Care Plan, Inc CurrentSince Aug 1, 2020 Accepting new patients
Florida Health Care Plan, Inc CurrentSince Aug 1, 2020 Accepting new patients

Locations

707 Platinum Pt
Lake Mary, FL 32746
Phone (386) 481-6774

740 Dunlawton Ave
Ste 200
Port Orange, FL 32127
Phone (386) 763-1000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1801045760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9671",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321209671",
            "telephone_number": "386-676-7130",
            "fax_number": "386-676-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 PLATINUM PT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465702",
            "telephone_number": "407-878-0910",
            "fax_number": "407-878-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILLAPPA",
        "first_name": "MUKTI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME102325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003694300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.