Vivant Health, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

VIVANT HEALTH, PLLC

Practice address

660 Glades Rd Ste 140
Boca Raton, FL 33431-6466

Phone

(561) 800-4570

Fax

(561) 800-4580

NPI assigned

Jun 27, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Prasanth Gogineni, MDNPI 1376641902

Title

President

Phone

(561) 800-2601

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Interoperability endpoints

• Direct secure messaging: prasanth.gogineni.1@29387.direct.athenahealth.com

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Prasanth Gogineni, MD

  • Internal Medicine Physician
  • Boca Raton, FL
  • NPI 1376641902
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1942987474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10425 S LAGO VISTA CIR",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330762970",
            "telephone_number": "561-800-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 GLADES RD STE 140",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316466",
            "telephone_number": "561-800-4570",
            "fax_number": "561-800-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVANT HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-27",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "GOGINENI",
        "authorized_official_first_name": "PRASANTH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-800-2601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "prasanth.gogineni.1@29387.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "EMR Connection",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "660 Glades Rd Ste 140",
            "city": "Boca Raton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334316466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Primary Care Clinic/Center in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.