NPIMap

Organization Active NPI

Riverview Cardiac Surgery PA

Doing business as Riverview Cardiac Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Bradenton, FL
National Provider Identifier
1922053115
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
RIVERVIEW CARDIAC SURGERY PA
Doing business as
Riverview Cardiac Surgery
Practice address
300 Riverside Dr E Ste 3100
Bradenton, FL 34208-1024
Phone
(941) 744-2640
Fax
(941) 744-2650
NPI assigned
May 24, 2006
Last updated
Nov 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Authorized official

Name
Daryn Mullholand, MBA
Title
Credentialing
Phone
(727) 647-1188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

300 Riverside Dr E Ste 3100
Bradenton, FL 34208-1024

Mailing address

300 Riverside Dr E Ste 3100
Bradenton, FL 34208-1024
Phone (941) 744-2640

Other practice location 1

250 2nd St E Ste 4G
Bradenton, FL 34208-1028
Phone (941) 744-2640

Other practice location 2

2237 US Highway 27 S
Sebring, FL 33870-4936
Phone (941) 744-2640

Other practice location 3

3052 Harbor Blvd Ste 2
Port Charlotte, FL 33952-6758
Phone (941) 744-2640

Other names 1

  • RIVERVIEW CARDIAC SURGERY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061102000148 FL Part B Supplier - Clinic/Group Practice 3274530456 Receives reassigned benefits from 8 practitioners
Practice locations: Bradenton, FL; Port Charlotte, FL; Sebring, FL

National Provider Directory

National Provider Directory

Locations

300 Riverside Dr E
Ste 3100
Bradenton, FL 34208
Phone (941) 744-2640

5304 4th Avenue Cir E
Bradenton, FL 34208
Phone (941) 744-2640

3052 Harbor Blvd
Ste 2
Port Charlotte, FL 33952
Phone (941) 744-2640

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1922053115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RIVERSIDE DR E STE 3100",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081024",
            "telephone_number": "941-744-2640",
            "fax_number": "941-744-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RIVERSIDE DR E STE 3100",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081024",
            "telephone_number": "941-744-2640",
            "fax_number": "941-744-2650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 2nd St E Ste 4G",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342081028",
            "country_code": "US",
            "telephone_number": "941-744-2640",
            "fax_number": "941-744-2650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2237 US Highway 27 S",
            "address_purpose": "LOCATION",
            "city": "Sebring",
            "state": "FL",
            "postal_code": "338704936",
            "country_code": "US",
            "telephone_number": "941-744-2640",
            "fax_number": "941-744-2650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3052 Harbor Blvd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "339526758",
            "country_code": "US",
            "telephone_number": "941-744-2640",
            "fax_number": "941-744-2650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RIVERVIEW CARDIAC SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "MULLHOLAND",
        "authorized_official_first_name": "DARYN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "727-647-1188",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RIVERVIEW CARDIAC SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.