Individual provider Active NPI

Ranganatha Prasad Potu, M.D.

  • Cardiovascular Disease Physician
  • Crystal River, FL
National Provider Identifier
1801851217
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME0036819 Issued in FL
Practice address
6122 W Corporate Oaks Dr
Crystal River, FL 34429-8722
Phone
(352) 228-8429
Fax
(352) 794-6326
NPI assigned
Apr 19, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME36819 FL
Cardiovascular Disease Physician 207RC0000X ME0036819 FL Primary

Addresses

Primary practice location

6122 W Corporate Oaks Dr
Crystal River, FL 34429-8722

Mailing address

6122 W Corporate Oaks Dr
Crystal River, FL 34429-8722
Phone (352) 228-8429

Other practice location 1

4224 N Gulf to Lake Highway
Lecanto, FL 34461-9215
Phone (352) 513-3482

Other identifiers 4

IdentifierTypeStateIssuer
001262401MedicaidFL
060000091OtherFLRAIL ROAD MEDICARE
09052OtherFLBLUE CROSS/BLUE SHIELD
095765662OtherFLTRI CARE FOR LIFE

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
I20080827000502 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9537195813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6122 W Corporate Oaks Dr
Crystal River, FL 34429-8722
Phone (352) 613-3105

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0036819FLMDCardiovascular Disease Physician
ME36819FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Potu Cardiology PL Cardiovascular Disease CurrentSince Sep 18, 2017 Accepting new patients
Robert Feldman MD PA Past Accepting new patients
Heart Associates PA Cardiovascular Disease Past Accepting new patients
Lake Cardiovascular Diagnostic Center L.L.C Cardiovascular Disease PastSince Nov 1, 2014 Accepting new patients

Locations

6122 W Corporate Oaks Dr
Crystal River, FL 34429
Phone (352) 228-8429

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/IEABBD/Endpoint/IEABBD
  • Direct secure messaging: rpotu296964@direct.tgh.org

Organizations & group practices 5

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 2

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1801851217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6122 W CORPORATE OAKS DR",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344298722",
            "telephone_number": "352-228-8429",
            "fax_number": "352-794-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6122 W CORPORATE OAKS DR",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344298722",
            "telephone_number": "352-228-8429",
            "fax_number": "352-794-6326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4224 N Gulf to Lake Highway",
            "address_purpose": "LOCATION",
            "city": "Lecanto",
            "state": "FL",
            "postal_code": "344619215",
            "country_code": "US",
            "telephone_number": "352-513-3482",
            "fax_number": "352-513-3489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTU",
        "first_name": "RANGANATHA",
        "middle_name": "PRASAD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME36819",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME0036819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001262401",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "060000091",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "09052",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI CARE FOR LIFE",
            "identifier": "095765662",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal River, FL

Sources for this page

Verify at the official NPI Registry.