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

Active since April 11, 2006CLIA 10D1060442 · Waiver
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: July 19, 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 holds a CLIA Waiver certificate valid through October 23, 2026 and 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
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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 ›

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
Active · expires 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.

Other Providers at the Same Location NPPES 3

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

ST. AUGUSTINE EAR, NOSE & THROAT, L.L.C.
Specialist
1301 PLANTATION ISLAND DRIVE, UNIT 401
SAINT AUGUSTINE, FL 32080
St. Johns County (904) 461-6060
SHERRI LEE MAETOZO MD PA
Obstetrics & Gynecology
1301 PLANTATION ISLAND DRIVE, STE 103
ST AUGUSTINE, FL 32080
St. Johns County (904) 461-5330
SHERRI LEE MAETOZO M.D.
Obstetrics & Gynecology
1301 PLANTATION ISLAND DRIVE, SUITE 103
ST AUGUSTINE, FL 32080
St. Johns County (904) 461-5330

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.

Does Anastasia Medical Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1060442) is associated with this NPI, valid through October 23, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 with the weekly NPPES data releases published by CMS.