Individual provider Active NPI

Carlos Alberto Podesta, M.D.

  • Cardiovascular Disease Physician
  • Cookeville, TN
National Provider Identifier
1881099885
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
60531 Issued in TN
Practice address
238 W 4TH St Ste 200
Cookeville, TN 38501
Phone
(931) 783-5582
NPI assigned
Nov 3, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TRN17376 FL
Interventional Cardiology Physician 207RI0011X 60531 TN
Cardiovascular Disease Physician 207RC0000X 60531 TN Primary

Addresses

Primary practice location

238 W 4TH St Ste 200
Cookeville, TN 38501

Mailing address

228 W 4TH St Ste 200
Cookeville, TN 38501-2489
Phone (931) 783-5582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20200722003141 TN Practitioner - Cardiovascular Disease (Cardiology) 7113341249 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRMC Mso Sub 1 IncorporatedGroup PAC ID 1052332830, 21 clinicians
Stern Cardiovascular Center, PAGroup PAC ID 2860390275, 126 clinicians

Practice addresses (Care Compare)

228 W 4TH St
Suite 200
Cookeville, TN 38501-2489
Phone (931) 372-0405

8060 Wolf River Blvd
Germantown, TN 38138-1727
Phone (901) 271-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
55.82 of 100Reported as individual
Quality
74.16
Promoting interoperability
0
Improvement activities
40
Cost
61.89

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting36
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN17376FLMDInternal Medicine Physician
60531TNMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CRMC Mso Sub 1, Incorporated CurrentSince Aug 10, 2020 Accepting new patients

Locations

228 W 4th St
Ste 200
Cookeville, TN 38501
Phone (931) 372-0405

106 Henry St
Crossville, TN 38555
Phone (931) 783-4770

207 W Bockman Way Ste B
Sparta, TN 38583

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.

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": "1414972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1881099885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 W 4TH ST STE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012489",
            "telephone_number": "931-783-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 W 4TH ST STE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "38501",
            "telephone_number": "931-783-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODESTA",
        "first_name": "CARLOS",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-03",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN17376",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TN",
            "license": "60531",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "60531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.