MEDICARE: DR. SASHI ADIGOPULA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	A124986	CA
2	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	ME179614	FL
3	207RC0000X	Cardiovascular Disease Physician	01083005A	IN
4	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	01083005A	IN
5	207RC0000X	Cardiovascular Disease Physician	A124986	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P02333687	OTHER	IN	RAILROAD MEDICARE
4	266180E87	OTHER	IN	TRADITIONAL MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	A124986	OTHER	CA	CALIFORNIA MEDICAL LICENSE NUMBER

General Provider Information

NPI Number	:	1053325050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SASHI ADIGOPULA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-468-8033
Fax Number	:	239-468-7953

Provider Business Practice Location Address
First Line	:	9981 S HEALTHPARK DR STE 454
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-3618
Country	:	US
Telephone Number	:	239-468-8033
Fax Number	:	239-468-7953

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	06/04/2026

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Directions to “ DR. SASHI ADIGOPULA M.D.” Practice Location

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