NPIMap

Individual provider Active NPI

Sushruth Edla, M.D.

  • Interventional Cardiology Physician
  • Lady Lake, FL
National Provider Identifier
1821343179
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME177940 Issued in FL
Practice address
8575 NE 138TH LN Ste 203
Lady Lake, FL 32159-8996
Phone
(352) 674-2080
NPI assigned
Jul 23, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.020812 OH
Interventional Cardiology Physician 207RI0011X ME177940 FL Primary
Cardiovascular Disease Physician 207RC0000X 2019014001 MO
Student in an Organized Health Care Education/Training Program 390200000X 57.020812 OH
Interventional Cardiology Physician 207RI0011X 2019014001 MO

Addresses

Primary practice location

8575 NE 138TH LN Ste 203
Lady Lake, FL 32159-8996

Mailing address

8575 NE 138TH LN Ste 203
Lady Lake, FL 32159-8996
Phone (636) 933-5055

Other practice location 1

2351 E 22nd St
#342W
Cleveland, OH 44115-3111
Phone (216) 363-2725

Other practice location 2

1390 US Highway 61 Ste N1500
Festus, MO 63028-4137
Phone (636) 933-5055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190619002318 MO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8224362603 Reassigns benefits to 1 organization
I20260320000369 FL Practitioner - Interventional CardiologyPractitioner - Internal Medicine 8224362603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Heart and Vascular LLCGroup PAC ID 8820016207, 112 clinicians
Heart of the Villages PLCGroup PAC ID 1850560954, 15 clinicians

Practice addresses (Care Compare)

1390 US Hwy 61
Suite N1500
Festus, MO 63028-4137
Phone (314) 251-1700

8575 NE 138TH Lane
Suite 203
Lady Lake, FL 32159-8996

8575 NE 138TH LN
Suite 203
Lady Lake, FL 32159-8996
Phone (352) 674-2080

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting19
Pacemaker insertion or repair1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME177940FLMDInterventional Cardiology Physician
57.020812OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC Past Accepting new patients
Heart of the Villages PLC Cardiovascular Disease PastSince Jan 13, 2014 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sedla425305@direct.hfhs.org
  • Direct secure messaging: sedla1029622@directc.mercy.net

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1821343179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8575 NE 138TH LN STE 203",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321598996",
            "telephone_number": "636-933-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 NE 138TH LN STE 203",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321598996",
            "telephone_number": "352-674-2080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2351 E 22nd St",
            "address_2": "#342W",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441153111",
            "country_code": "US",
            "telephone_number": "216-363-2725",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1390 US Highway 61 Ste N1500",
            "address_purpose": "LOCATION",
            "city": "Festus",
            "state": "MO",
            "postal_code": "630284137",
            "country_code": "US",
            "telephone_number": "636-933-5055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDLA",
        "first_name": "SUSHRUTH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-23",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.020812",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME177940",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2019014001",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "57.020812",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2019014001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

Verify at the official NPI Registry.