SAN THAWALANTHANNE
NPI 1275397622
Nurse Practitioner - Psychiatric/Mental Health in Longwood, FL

Active since February 07, 2024PECOS EnrolledAccepts Medicare Assignment
2290 N RONALD REAGAN BLVD STE 116, LONGWOOD, FL 32750(407) 215-0095(407) 261-0523 Get Directions Write a Review

NPPES record last updated: November 4, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 4, 2024, Aug 8, 2024, Feb 7, 2024 (3 updates tracked since 2024).

About San Thawalanthanne NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAN THAWALANTHANNE (NPI 1275397622) is an individual psychiatric/mental health provider in Longwood, Florida, licensed in Florida (11031100) and active in the NPI registry since February 2024. He is enrolled in Medicare PECOS, maintains a secondary practice location in Brandon, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1275397622
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameSAN THAWALANTHANNE
Location Address2290 N RONALD REAGAN BLVD STE 116Longwood, FL 32750-3534
Mailing Address1000 S Lake DrClearwater, FL 33756-4415 · (815) 451-2897
Fax(407) 261-0523
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateFebruary 7, 2024
Last NPPES UpdateNovember 4, 20243 updates tracked since enumeration
NPPES CertifiedNovember 4, 2024
NPI 1275397622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in FL · 11031100
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
2290 N RONALD REAGAN BLVD STE 116, Longwood, FL 32750

Secondary Practice Location 1

Location 1106 W Windhorst RdBrandon, FL 33510-2455 · Phone (813) 373-9531

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

San Thawalanthanne is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7618418484
PECOS Enrollment IDI20240919002730
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32750 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor
2290 N RONALD REAGAN BLVD STE 116
LONGWOOD, FL 32750
Psychologist (Counseling)
2290 N RONALD REAGAN BLVD STE 116
LONGWOOD, FL 32750
Registered Nurse
2290 N RONALD REAGAN BLVD STE 116
LONGWOOD, FL 32750
Case Manager/Care Coordinator
2290 N RONALD REAGAN BLVD STE 116
LONGWOOD, FL 32750
Community/Behavioral Health
2290 N RONALD REAGAN BLVD STE 116
LONGWOOD, FL 32750
Counselor
2290 N RONALD REAGAN BLVD STE 116
LONGWOOD, FL 32750
Counselor (School)
2290 N RONALD REAGAN BLVD STE 116
LONGWOOD, FL 32750
Registered Nurse
2290 N RONALD REAGAN BLVD STE 116
LONGWOOD, FL 32750

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is San Thawalanthanne's NPI number?

The NPI number for San Thawalanthanne is 1275397622. It was assigned to this individual provider in the NPPES registry on February 7, 2024.

Where is San Thawalanthanne located?

San Thawalanthanne practices at 2290 N Ronald Reagan Blvd Ste 116, Longwood, FL 32750. The listed phone number is (407) 215-0095.

What is San Thawalanthanne's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is San Thawalanthanne enrolled in Medicare?

Yes. San Thawalanthanne is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does San Thawalanthanne accept?

Health plans from Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Oscar Health Maintenance Organization of Florida and 3 other insurers list San Thawalanthanne as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for San Thawalanthanne was last updated on November 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.