LEGACY HEALTH MEDICAL GROUP, LLC – Multi-Specialty Clinic/Center, NPI 1881942779

LEGACY HEALTH MEDICAL GROUP, LLC is a healthcare provider. based in Largo, Florida. specializing in Multi-Specialty Clinic/Center. The organization holds a License No. ME105069 (FL). The NPI Number for LEGACY HEALTH MEDICAL GROUP, LLC is 1881942779

Main info

Organization
Name
LEGACY HEALTH MEDICAL GROUP, LLC
NPI
1881942779
Phone
(727) 489-3305
Address
3500 OAK MANOR LN # 46
Authorized Official
DR. SUNIT SRIVASTAVA MANAGING MEMBER M.D.
Enumeration Date
27 August 2012
Last Update Date
26 September 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness85
Years active:13State licenses:1Digital endpointsOther names

Provider Addresses for LEGACY HEALTH MEDICAL GROUP, LLC

  • 3500 OAK MANOR LN # 46

    LARGO, FL 337741211

    Phone: (727) 489-3305

    Fax: (727) 499-9559

    Type: Location

  • 801 W BAY DR STE 605

    LARGO, FL 337703268

    Phone: (727) 489-3305

    Fax: (727) 499-9559

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-05-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20130510000372OClinic/Group PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33774)

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Reviews

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Frequently asked questions

Where can patients find LEGACY HEALTH MEDICAL GROUP, LLC's NPI?
You can confirm LEGACY HEALTH MEDICAL GROUP, LLC with NPI 1881942779; it appears in the national provider directory.
Does this profile mean LEGACY HEALTH MEDICAL GROUP, LLC is currently active?
Yes — LEGACY HEALTH MEDICAL GROUP, LLC appears active in the national provider directory.
Can you summarize LEGACY HEALTH MEDICAL GROUP, LLC's specialty in plain language?
Clinically, the directory lists LEGACY HEALTH MEDICAL GROUP, LLC with Multi-Specialty Clinic/Center. Clinical services aligned with this taxonomy classification.
What location shows for LEGACY HEALTH MEDICAL GROUP, LLC?
We surface Largo, Florida for LEGACY HEALTH MEDICAL GROUP, LLC based on available NPPES addresses.
Is LEGACY HEALTH MEDICAL GROUP, LLC a real provider?
This page reflects official NPPES data for NPI 1881942779. Always confirm identity and privileges with the practice and licensing boards.

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