Individual provider Active NPI

Tracie L Patel, PA

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1003828351
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9102082 Issued in FL
Practice address
10740 Palm River Rd Ste 360
Tampa, FL 33619-4578
Phone
(813) 844-7585
Fax
(813) 844-5877
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9102082 FL Primary

Addresses

Primary practice location

10740 Palm River Rd Ste 360
Tampa, FL 33619-4578

Mailing address

PO Box 1289
Tampa, FL 33601-1289
Phone (813) 844-8927

Other practice location 1

12901 Bruce B Downs Blvd
Tampa, FL 33612-4742
Phone (813) 974-2201

Other practice location 2

2 Tampa General Cir # 6459K
Tampa, FL 33606-3603
Phone (813) 844-4545

Other identifiers 2

IdentifierTypeStateIssuer
291352600MedicaidFL
Y00S9OtherFLBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tpatel8675@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100308000773 FL Practitioner - Physician Assistant 7719022250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tampa General Medical Group IncGroup PAC ID 7416253828, 353 clinicians

Practice addresses (Care Compare)

17416 Brookside Trace CT
Tampa, FL 33647-6200
Phone (813) 660-6150

214 Morrison Rd
Suite 110
Brandon, FL 33511-4849
Phone (813) 844-4300

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Medical Group Inc CurrentSince Sep 7, 2021 Accepting new patients
Tampa General Hospital Current Accepting new patients
Tampa General Medical Group Inc CurrentSince Sep 7, 2021 Accepting new patients
Tampa General Medical Group Inc Past Accepting new patients

Locations

214 Morrison Rd
Ste 110
Brandon, FL 33511
Phone (800) 844-9302

14131 Metropolis Ave
Ste 103
Fort Myers, FL 33912
Phone (239) 224-3501

17416 Brookside Trace Ct
Tampa, FL 33647
Phone (813) 660-6150

10740 Palm River Rd
Ste 360
Tampa, FL 33619
Phone (813) 660-6400

2433 Country Place Blvd
Trinity, FL 34655
Phone (813) 844-8200

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: tpatel8675@direct.tgh.org

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1003828351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336011289",
            "telephone_number": "813-844-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10740 PALM RIVER RD STE 360",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194578",
            "telephone_number": "813-844-7585",
            "fax_number": "813-844-5877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12901 Bruce B Downs Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336124742",
            "country_code": "US",
            "telephone_number": "813-974-2201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Tampa General Cir # 6459K",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063603",
            "country_code": "US",
            "telephone_number": "813-844-4545",
            "fax_number": "813-844-3976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "TRACIE",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291352600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y00S9",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tpatel8675@direct.tgh.org",
            "affiliation": "N",
            "address_1": "10740 Palm River Rd Ste 360",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336194578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.