Krishna M Ganti MD PA

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

ME48997 Issued in FL

Legal business name

KRISHNA M GANTI MD PA

Practice address

11373 Cortez Blvd
Suite 203
Brooksville, FL 34613-5414

Phone

(352) 596-6158

Fax

(352) 596-6186

NPI assigned

Jan 5, 2009

Organization subpart

No

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

Authorized official

Name

Krishna M Ganti, MDNPI 1063413128

Title

Initial Officer and/Or Director

Phone

(352) 596-6158

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

Practitioners 1

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.

• Krishna M Ganti, M.D.

  • Specialist
  • Brooksville, FL
  • NPI 1063413128
  Authorized official Same address or phone

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248825600000",
    "number": "1952547507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11373 CORTEZ BLVD",
            "address_2": "SUITE 203",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135414",
            "telephone_number": "352-596-6158",
            "fax_number": "352-596-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11373 CORTEZ BLVD",
            "address_2": "SUITE 203",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135414",
            "telephone_number": "352-596-6158",
            "fax_number": "352-596-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISHNA M GANTI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-05",
        "last_updated": "2009-07-29",
        "status": "A",
        "authorized_official_last_name": "GANTI",
        "authorized_official_first_name": "KRISHNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "INITIAL OFFICER AND/OR DIRECTOR",
        "authorized_official_telephone_number": "352-596-6158",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME48997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NPI",
            "identifier": "1952547507",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "40001752",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57664600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "09499",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS FLORIDA",
            "identifier": "02407",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL NPI",
            "identifier": "1063413128",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE  INDIVIDUAL PTAN",
            "identifier": "02407Y",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "BJ359",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gopal R Korupolu, M.D.
• Ciana Alliyah Martins Kraft, MA
• Mark A T Kranc, M.D.
• Amy Kraus
• Teddi Kriegsman, RMHCI
• Vamsi Krishna Krishnamaneni
• Linda Kruger
• Tauland Kruja, DMD
• Paulina Krzyzanowski
• Alexander Friedrich Kuffer, MD, DMD, PHD

• Otolaryngology Physician in Brooksville, FL
• Providers in Brooksville, FL by specialty
• Otolaryngology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.