The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Davie and Florida

127 active clinicians are listed under Pharmacist with a practice address in Davie, FL (19,430 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Davie

0% of these 127 clinicians have the CMS telehealth indicator.

0% of these 127 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

License # reported to NPPES FL PS57177

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.

Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Other Identifier Nabp

888892 (FL)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

13 Historical Events

✅

NPI Profile Active October 02, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location October 02, 2017

Registered at 6968 SW 39TH ST, 301, DAVIE, FL 333142413 (Tel: 6464382721)

📍

Updated Business Mailing Address October 02, 2017

Registered at 6968 SW 39TH ST, 301, DAVIE, FL 333142413 (Tel: 6464382721)

👤

Provider Name / Credentials Updated October 02, 2017

Recorded as PRADEEP KOMARNENI

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 02, 2017

Pharmacist (license number reported to NPPES: FL PS57177)

📍

Updated Practice Location January 16, 2017

Registered at 6968 SW 39TH ST, 301, DAVIE, FL 333142413 (Tel: 6464382721)

📍

Updated Business Mailing Address January 16, 2017

Registered at 6968 SW 39TH ST, 301, DAVIE, FL 333142413 (Tel: 6464382721)

✅

NPI Profile Active October 06, 2014

NPI status registered as active in NPPES database

📍

Practice Location (Initial Record) October 06, 2014

Registered at 7081 NW 16TH ST, APT #B316, PLANTATION, FL 333135271 (Tel: 6464382721)

📍

Business Mailing Address (Initial Record) October 06, 2014

Registered at 7081 NW 16TH ST, APT #B316, PLANTATION, FL 333135271 (Tel: 6464382721)

👤

Provider Name / Credentials (Initial Record) October 06, 2014

Recorded as PRADEEP KOMARNENI

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 06, 2014

Student in an Organized Health Care Education/Training Program

🟢

Initial NPI Registration & Enumeration October 06, 2014

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1306249222

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 06, 2014

Last Update: October 02, 2017

Sole Proprietor: Yes

Update or Correct Profile

Other Pharmacists in Davie

All Pharmacists in Davie

Mailing Address

6968 Sw 39th St, 301

Davie, FL 333142413

Phone: 6464382721

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.