Active NPI
Peter Michael Pardoll, M.D.
- Gastroenterology Physician
- Treasure Island, FL
National Provider Identifier
1013288604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- ME24487
- Practice address
- 34 Paradise LN
Treasure Island, FL 33706-1129 - Phone
- (727) 422-5464
- Fax
- (727) 360-5352
- NPI assigned
- Jan 13, 2012
- Last updated
- Jan 13, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | ME24487 | FL | Primary |
Addresses
Primary practice location
34 Paradise LN
Treasure Island, FL 33706-1129
Mailing address
34 Paradise Lane
Treasure Island, FL 33706
Phone (727) 422-5464
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME24487 | FL | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326412800000",
"number": "1013288604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 PARADISE LANE",
"city": "TREASURE ISLAND",
"state": "FL",
"postal_code": "33706",
"telephone_number": "727-422-5464",
"fax_number": "727-360-5352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 PARADISE LN",
"city": "TREASURE ISLAND",
"state": "FL",
"postal_code": "337061129",
"telephone_number": "727-422-5464",
"fax_number": "727-360-5352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARDOLL",
"first_name": "PETER",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-13",
"last_updated": "2012-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "ME24487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Treasure Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.