Individual provider Active NPI

Juan Carlos Cardet Guisasaola, MD

  • Allergy & Immunology Physician
  • Tampa, FL
National Provider Identifier
1003071713
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
ME133105 Issued in FL
Practice address
13330 Usf Laurel Dr
Tampa, FL 33612-6601
Phone
(813) 974-2201
NPI assigned
Jul 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 247405 MA
Internal Medicine Physician 207R00000X 12022R PR
Allergy & Immunology Physician 207K00000X ME133105 FL Primary

Addresses

Primary practice location

13330 Usf Laurel Dr
Tampa, FL 33612-6601

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other identifiers 2

IdentifierTypeStateIssuer
022650100MedicaidFL
IFANCOtherFLBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcardetguisasola135437@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180130000702 FL Practitioner - Allergy/Immunology 7911145768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Puerto Rico School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

13330 Usf Laurel Dr
Suite 3
Tampa, FL 33612-6601
Phone (813) 396-9422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME133105FLMDAllergy & Immunology Physician
12022RPRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc Internal Medicine CurrentSince Nov 30, 2017 Accepting new patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince Nov 30, 2017 Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

5802 N 30th St
Tampa, FL 33610
Phone (813) 236-5100

13330 Usf Laurel Dr
Fl 3
Tampa, FL 33612
Phone (813) 396-9422

13330 Usf Laurel Dr
Tampa, FL 33612
Phone (813) 396-9478

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

Networks

  • Freedom Health HMO Network
  • FL HMO D-SNP
  • FL HMO
  • FL PPO
  • FL HMO C-SNP

Interoperability endpoints

  • Direct secure messaging: jcardetguisasola135437@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1003071713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13330 USF LAUREL DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336126601",
            "telephone_number": "813-974-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDET GUISASAOLA",
        "first_name": "JUAN CARLOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MA",
            "license": "247405",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "12022R",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME133105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022650100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "IFANC",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcardetguisasola135437@direct.tgh.org",
            "affiliation": "N",
            "address_1": "13330 Usf Laurel Dr",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336126601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.