Individual provider Active NPI

Jeffery Allen Prosser, M.D.

  • Family Medicine Physician
  • Tarpon Springs, FL
National Provider Identifier
1023154515
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME81606 Issued in FL
Practice address
905 E Martin Luther King Jr Dr Ste 390
Tarpon Springs, FL 34689-4828
Phone
(727) 940-7664
Fax
(727) 940-7710
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME81606 FL Primary

Addresses

Primary practice location

905 E Martin Luther King Jr Dr Ste 390
Tarpon Springs, FL 34689-4828

Mailing address

PO Box 2348
Tarpon Springs, FL 34688-2348
Phone (727) 940-7664

Other identifiers 1

IdentifierTypeStateIssuer
00614755MedicaidFL

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
I20051230000408 FL Practitioner - Hospice/Palliative Care 1658393871 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Albany Medical College of Union University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

905 E Martin Luther King Jr Dr
Suite 390
Tarpon Springs, FL 34689-4828

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospice of the Florida Suncoast, Inc. Family Medicine CurrentSince Aug 4, 2022 Accepting new patients
Empath Health Pharmaceuticals, LLC CurrentSince Aug 4, 2022 Accepting new patients
Empath Community Health LLC CurrentSince Nov 2, 2015 Accepting new patients
Withall & Associates Consulting, Inc. Past Accepting new patients

Locations

5771 Roosevelt Blvd
Clearwater, FL 33760
Phone (727) 523-2480

5771 Roosevelt Blvd
Ste 610
Clearwater, FL 33760
Phone (727) 523-2160

6310 Capital Dr
Lakewood Ranch, FL 34202
Phone (941) 552-7500

2675 Tampa Rd
Palm Harbor, FL 34684
Phone (727) 467-7423

6770 102nd Ave N
Pinellas Park, FL 33782
Phone (727) 523-2460

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 1

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1023154515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2348",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346882348",
            "telephone_number": "727-940-7664",
            "fax_number": "727-940-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 E MARTIN LUTHER KING JR DR STE 390",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346894828",
            "telephone_number": "727-940-7664",
            "fax_number": "727-940-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSSER",
        "first_name": "JEFFERY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME81606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00614755",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarpon Springs, FL

Sources for this page

Verify at the official NPI Registry.