ANASTASIA MEDICAL GROUP, LLC – NPI #1710940648
Internal Medicine

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

ANASTASIA MEDICAL GROUP, LLC is a provider located in SAINT AUGUSTINE, FL. NPPES has assigned the NPI number 1710940648 to ANASTASIA MEDICAL GROUP, LLC on April 11, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207R00000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine.

The NPI profile was previously updated about 2 years ago on Jan 15, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ANASTASIA MEDICAL GROUP, LLC below.

NPI Profile for
ANASTASIA MEDICAL GROUP, LLC

NPI Number
1710940648
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ANASTASIA MEDICAL GROUP, LLC
Primary location
1301 PLANTATION ISLAND DRIVE
SUITE 203A
SAINT AUGUSTINE, FL 32080
Phone: (904) 461-0821 Fax: (904) 461-0823
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SUHAS NEERUKONDA
MANAGING PARTNER
Phone: (904) 461-0343
Updated
Certification Date
Jan 15, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for ANASTASIA MEDICAL GROUP, LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherBCBSFL99767
medicaidFL277020200
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207R00000X
- Internal Medicine (Primary)
213E00000X
- Podiatrist
207RE0101X
- Internal Medicine / Endocrinology, Diabetes & Metabolism

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.