Active NPI
Issam I Albanna, MD
- Pediatrics Physician
- Tampa, FL
National Provider Identifier
1023007135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME0061731
- Practice address
- 3288 Cove Bend Dr
Tampa, FL 33613-2752 - Phone
- (813) 979-4435
- Fax
- (813) 979-4026
- NPI assigned
- Oct 20, 2005
- Last updated
- Nov 3, 2011
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME0061731 | FL | Primary |
Addresses
Primary practice location
3288 Cove Bend Dr
Tampa, FL 33613-2752
Mailing address
3288 Cove Bend Dr
Tampa, FL 33613-2752
Phone (813) 979-4435
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 379455500 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0061731 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Medical Associates LLC | Past | Accepting new patients | |
| Primary Medical Care R Ayala MD PA | Past | Accepting new patients | |
| Issam Albanna, MD, PA | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DGAIBA/Endpoint/DGAIBA
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Family Medical Center
- Multi-Specialty Clinic/Center
- Dade City, FL
- NPI 1790799526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320278400000",
"number": "1023007135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3288 COVE BEND DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336132752",
"telephone_number": "813-979-4435",
"fax_number": "813-979-4026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3288 COVE BEND DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336132752",
"telephone_number": "813-979-4435",
"fax_number": "813-979-4026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALBANNA",
"first_name": "ISSAM",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-20",
"last_updated": "2011-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME0061731",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "379455500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.