Organization Active NPI

Durairaj Venkatasamy MD PA

  • Internal Medicine Physician
  • Plantation, FL
National Provider Identifier
1982664348
Registry record updated Nov 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME80895 Issued in FL
Legal business name
DURAIRAJ VENKATASAMY MD PA
Practice address
9633 W Broward Blvd
Suite 5
Plantation, FL 33324-2332
Phone
(954) 474-4500
Fax
(954) 474-4559
NPI assigned
Mar 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2010

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

Authorized official

Name
Dr. Durairaj Venkatasamy, M.DNPI 1619938719
Title
President
Phone
(954) 474-4500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME80895 FL Primary

Addresses

Primary practice location

9633 W Broward Blvd
Suite 5
Plantation, FL 33324-2332

Mailing address

9633 W Broward Blvd
Suite 5
Plantation, FL 33324-2332
Phone (954) 474-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050428000724 FL Part B Supplier - Clinic/Group Practice 9739128786 Receives reassigned benefits from 1 practitioner
Practice locations: Plantation, FL

National Provider Directory

National Provider Directory

Locations

9633 W Broward Blvd
Ste 5
Plantation, FL 33324
Phone (954) 474-4500

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290556800000",
    "number": "1982664348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9633 W BROWARD BLVD",
            "address_2": "SUITE 5",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242332",
            "telephone_number": "954-474-4500",
            "fax_number": "954-474-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9633 W BROWARD BLVD",
            "address_2": "SUITE 5",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242332",
            "telephone_number": "954-474-4500",
            "fax_number": "954-474-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DURAIRAJ VENKATASAMY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2010-11-24",
        "status": "A",
        "authorized_official_last_name": "VENKATASAMY",
        "authorized_official_first_name": "DURAIRAJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-474-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME80895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.