1. Home
  2. Directory
  3. Florida
  4. St Augustine
  5. Internal Medicine
  6. NPI Profile

ANASTASIA MEDICAL GROUP, LLC
NPI 1710940648
Internal Medicine in St Augustine, FL

Active since April 11, 2006
1301 PLANTATION ISLAND DRIVE, SUITE 203A, ST AUGUSTINE, FL 32080(904) 461-0821(904) 461-0823 Get Directions Write a Review

NPPES record last updated: January 15, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Anastasia Medical Group, Llc NPPES

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

ANASTASIA MEDICAL GROUP, LLC (NPI 1710940648) is a healthcare organization registered as an internal medicine in St Augustine, Florida and active in the NPI registry since April 2006. The organization lists Suhas P Neerukonda, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1710940648
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameANASTASIA MEDICAL GROUP, LLC
Location Address1301 PLANTATION ISLAND DRIVE, SUITE 203ASt Augustine, FL 32080
Mailing Address1301 Plantation Island Drive, Suite 203aSt Augustine, FL 32080 · (904) 461-0821 · Fax (904) 461-0823
Phone(904) 461-0821
Fax(904) 461-0823
Organization SubpartNo
Authorized OfficialSuhas P NeerukondaManaging Partner · (904) 461-0343
Enumeration DateApril 11, 2006
Last NPPES UpdateJanuary 15, 2024
NPPES CertifiedJanuary 15, 2024
✔ NPI 1710940648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
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.
Also ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X
Also ListedPodiatristTaxonomy 213E00000X
1301 PLANTATION ISLAND DRIVE, St Augustine, FL 32080
Open in Google Maps ↗

Other Identifiers 2

Other99767FL · Bcbs
Medicaid277020200FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Anastasia Medical Group, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Anastasia Medical Group, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Cindy Chaconas, DPT, ATC
Physical Therapist in Private Practice
NPI 1518339761
1301 PLANTATION ISLAND DR S SUITE 203A
St Augustine, FL 32080
(904) 461-0821
✔ Accepts MedicareSame address
Suhas Neerukonda, MD
Internal Medicine
NPI 1538145602
1301 PLANTATION ISLAND DR SUITE 203
St Augustine, FL 32080
(904) 461-0821
✔ PECOS✔ Accepts MedicareSame address
Ryan Pereira, DPM
Podiatry
NPI 1033195979
1301 PLANTATION ISLAND DR S STE 203
St Augustine, FL 32080
(904) 461-0821
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1060442

Anastasia Medical Group, LLC · Saint Augustine, FL
Expired · Oct 23, 2026
CLIA Number10D1060442
Laboratory TypePhysician Office
Certificate Effective DateOctober 24, 2024
Certificate Expiration DateOctober 23, 2026
Laboratory DirectorSuhas Neerukonda
Laboratory Phone(904) 461-0821
Laboratory LocationAnastasia Medical Group, LLC1301 Plantation Island Dr Suite 203, Saint Augustine, FL 32080
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Anastasia Medical Group, LLC's NPI number?

The NPI number for Anastasia Medical Group, LLC is 1710940648. It was assigned to this organization in the NPPES registry on April 11, 2006.

Where is Anastasia Medical Group, LLC located?

Anastasia Medical Group, LLC is located at 1301 Plantation Island Drive Suite 203A, St Augustine, FL 32080. The listed phone number is (904) 461-0821.

What is Anastasia Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Anastasia Medical Group, LLC enrolled in Medicare?

Yes. Anastasia Medical Group, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Anastasia Medical Group, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Anastasia Medical Group, LLC, in Internal Medicine, Physical Therapist in Private Practice and Podiatry. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Anastasia Medical Group, LLC accept?

Health plans from AvMed list Anastasia Medical Group, LLC 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 Anastasia Medical Group, LLC was last updated on January 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.