Individual provider Active NPI

Chandra S Bomma, MD

  • Clinical Cardiac Electrophysiology Physician
  • Orlando, FL
National Provider Identifier
1962517433
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
ME106874 Issued in FL
Practice address
1613 N Mills Ave
Orlando, FL 32803-1849
Phone
(407) 894-4474
Fax
(407) 894-7136
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0101243472 VA
Internal Medicine Physician 207R00000X D0059614 MD
Cardiovascular Disease Physician 207RC0000X MD.200418 LA
Clinical Cardiac Electrophysiology Physician 207RC0001X ME106874 FL Primary

Addresses

Primary practice location

1613 N Mills Ave
Orlando, FL 32803-1849

Mailing address

1613 N Mills Ave
Orlando, FL 32803-1849
Phone (407) 894-4474

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100729000389 FL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiac Surgery 7416849534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

1613 N Mills Ave
Orlando, FL 32803-1849
Phone (407) 894-4474

2100 Ocoee Apopka Rd
Apopka, FL 32703-9210

258 S Chickasaw TRL
Orlando, FL 32825-3501

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

689 E Altamonte Dr
Altamonte Springs, FL 32701-4801
Phone (407) 894-4474

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0059614MDMDInternal Medicine Physician
MD.200418LAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Aug 8, 2016 Accepting new patients
Central Florida Cardiology Interpretations LLC CurrentSince Aug 20, 2013 Accepting new patients
Florida Hospital Medical Group Inc Internal Medicine CurrentSince Aug 8, 2016 Accepting new patients
Cardiac Clinic of Sunil M. Kakkar, M.D, P.a Cardiovascular Disease CurrentSince Jul 19, 2010 Accepting new patients

Locations

311 W Oak St
Kissimmee, FL 34741
Phone (407) 933-1423

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1613 N Mills Ave
Orlando, FL 32803
Phone 40789444741145

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: cbomma73551@adventhealth.direct-ci.com

Organizations & group practices 4

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1962517433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031849",
            "telephone_number": "407-894-4474",
            "fax_number": "407-894-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031849",
            "telephone_number": "407-894-4474",
            "fax_number": "407-894-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMMA",
        "first_name": "CHANDRA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101243472",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0059614",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "MD.200418",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "FL",
            "license": "ME106874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.