Madhavi Kondur Muppala, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME121338 Issued in FL

Practice address

1845 Holsonback Dr
Daytona Beach, FL 32117-5114

Phone

(386) 274-0500

NPI assigned

Apr 28, 2009

Last updated

May 9, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Family Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Department of HealthGroup PAC ID 3072424282, shared by 68 NPIs, 126 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Florida Department of Health

  dba Flagler County Health Department

  • Public Health or Welfare Agency
  • Bunnell, FL
  • NPI 1285600213
  Medicare reassignment NPD
• Florida Department of Health

  dba Volusia County Health Department

  • Public Health or Welfare Agency
  • Daytona Beach, FL
  • NPI 1831158039
  Medicare reassignment NPD
• Florida Department of Health

  dba Levy County Health Department

  • Public Health or Welfare Agency
  • Bronson, FL
  • NPI 1154395390
  NPD

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1902040462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10855 EMERALD CHASE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328365881",
            "telephone_number": "270-404-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 HOLSONBACK DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175114",
            "telephone_number": "386-274-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Dr Carter Blvd",
            "address_purpose": "LOCATION",
            "city": "Bunnell",
            "state": "FL",
            "postal_code": "321106212",
            "country_code": "US",
            "telephone_number": "386-437-7350",
            "fax_number": "386-437-7350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONDUR MUPPALA",
        "first_name": "MADHAVI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME121338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Kay Koevenig, RD, LD/N, CDE
• Michael D Kohen, M.D.
• Frank R Kohler Jr., D.O.
• Sutinder Singh Kohli, BDS,MS,FAGD
• Bassem Koleilat, MD
• Sarah Stidham Koontz, MS, CCC-SLP
• Gina Alexandria Kopacki-Birt, LMHC
• Kopuri Orthodontist PA
• Brittany Dawn Korell, NP
• Kathleen Marie Korem Sperry, ARNP-BC

• Family Medicine Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; 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.