| Citrus Hospitalists Pa | |
|
6201 N Suncoast Blvd Crystal River FL 34428-6712 | |
| (732) 335-6512 | |
| (732) 305-8026 |
| Full Name | Citrus Hospitalists Pa |
|---|---|
| Speciality | Hospitalist |
| Location | 6201 N Suncoast Blvd, Crystal River, Florida |
| Authorized Official Name and Position | Chakradhar Desaraju (OWNER) |
| Authorized Official Contact | 3526012375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Citrus Hospitalists Pa 3600 N Grayhawk Loop Lecanto FL 34461-8468 Ph: () - | Citrus Hospitalists Pa 6201 N Suncoast Blvd Crystal River FL 34428-6712 Ph: (732) 335-6512 |
| NPI Number | 1861195620 |
|---|---|
| Provider Enumeration Date | 03/22/2023 |
| Last Update Date | 03/22/2023 |
| Medicare PECOS PAC ID | 1052776655 |
|---|---|
| Medicare Enrollment ID | O20230504001035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861195620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208M00000X | Hospitalist | (* (Not Available)) | Primary |
| Provider Name | Chakradhar Desaraju |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558344069 PECOS PAC ID: 5597797712 Enrollment ID: I20050908000210 |
| Provider Name | Kamalakar Amaravadi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417149873 PECOS PAC ID: 7416044243 Enrollment ID: I20071026000074 |
| Provider Name | William S Gruss |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306982491 PECOS PAC ID: 5698852234 Enrollment ID: I20080408000131 |
| Provider Name | Rama R Kompella |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689871840 PECOS PAC ID: 3173611894 Enrollment ID: I20091005000311 |
| Provider Name | Cynthia Sue Hopper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750629804 PECOS PAC ID: 0345495909 Enrollment ID: I20130305000215 |
| Provider Name | Mary Ann Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194159301 PECOS PAC ID: 3779717830 Enrollment ID: I20131004000161 |
| Provider Name | Renee Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174920359 PECOS PAC ID: 5193041424 Enrollment ID: I20150304002306 |
| Provider Name | Nilesh G Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760822159 PECOS PAC ID: 4385931369 Enrollment ID: I20181217000593 |
| Provider Name | Svetlana Dial |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346723129 PECOS PAC ID: 8224449806 Enrollment ID: I20201203000931 |
| Provider Name | Nikalina Leliea Dundas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942920251 PECOS PAC ID: 2365809878 Enrollment ID: I20230526001307 |
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