Sarada Penukonda, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0067197 Issued in FL

Practice address

323 Del Prado Blvd S Ste 100
Cape Coral, FL 33990-1747

Phone

(239) 574-3382

Fax

(239) 574-5897

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Physical Therapy and Rehab of Cape Coral LLCGroup PAC ID 1951439660, 64 clinicians

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Millennium Home Care LLC Home health agency, Port Charlotte, FL, CCN 109401
• Pinnacle Home Care Home health agency, Fort Myers, FL, CCN 683113
• Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: sarada.penukonda.1@4290.direct.athenahealth.com

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.

• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Sarada Penukonda MD

  • Internal Medicine Physician
  • Cape Coral, FL
  • NPI 1801281928
  NPD (past) Authorized official
• Advanced Physical Therapy & Rehab of Cape Coral, LLC

  • Physical Therapy Clinic/Center
  • Cape Coral, FL
  • NPI 1891990206
  Care Compare group
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lee Health System Inc

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation
• Lee Health System Inc

  • General Acute Care Hospital
  • Cape Coral, FL
  • NPI 1780429076
  Care Compare affiliation
• Millennium Home Care LLC

  • Home Health Agency
  • Port Charlotte, FL
  • NPI 1700058583
  Care Compare affiliation
• Pinnacle Home Care of SW Florida, LLC

  • Home Health Agency
  • Fort Myers, FL
  • NPI 1720592751
  Care Compare affiliation

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1992887061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 DEL PRADO BLVD S STE 100",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339901747",
            "telephone_number": "239-574-3382",
            "fax_number": "239-574-5897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENUKONDA",
        "first_name": "SARADA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0067197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250647500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer E Pena, PT, DPT
• Maydelis De la Caridad Pena
• Matt Jospeh Penano, PHARM.D
• John R Penland, DC
• Arun K Penukonda, MD, FRCS, PA
• Jacob Peplow, PHARM-D
• Zahily Peraza-Higgins, ARNP
• Natalia Perdomo Alvarino
• Brieanna Lee Perdue
• Betty Pereda Herrera

• Internal Medicine Physician in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.