NPIMap

Individual provider Active NPI

Charles E Sanders Jr., M.D.

  • Nephrology Physician
  • Temple Terrace, FL
National Provider Identifier
1033112255
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME62847 Issued in FL
Practice address
12662 Telecom Dr
Temple Terrace, FL 33637-0935
Phone
(813) 910-8708
Fax
(855) 852-7153
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME62847 FL Primary

Addresses

Primary practice location

12662 Telecom Dr
Temple Terrace, FL 33637-0935

Mailing address

409 Bayshore Blvd
Tampa, FL 33606-2707
Phone (800) 844-9302

Other identifiers 2

IdentifierTypeStateIssuer
18235XOtherFLMEDICARE PTAN
371667800MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100305000143 FL Practitioner - Nephrology 1557330461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Louisiana State University School of Medicine in Shreveport, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

409 Bayshore Blvd
FL 4
Tampa, FL 33606-2707
Phone (813) 910-8708

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
70.52
Promoting interoperability
100
Improvement activities
40
Cost
73.91

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney Physicians , LLC Nephrology CurrentSince Oct 11, 2016 Accepting new patients
Florida Kidney Physicians, LLC Nephrology CurrentSince Oct 11, 2016 Accepting new patients
Tampa General Hospital Current Accepting new patients
Lifelink Healthcare Institute Inc Past Accepting new patients

Locations

409 Bayshore Blvd
Fl 4
Tampa, FL 33606
Phone (813) 910-8708

4710 N Habana Ave
Ste 107
Tampa, FL 33614
Phone (813) 870-3767

409 Bayshore Blvd
Tampa, FL 33606
Phone (813) 253-2640

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: charles.sanders.1@15644.direct.athenahealth.com
  • Direct secure messaging: csanders8151@direct.tgh.org

Organizations & group practices 4

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 4

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1033112255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 BAYSHORE BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062707",
            "telephone_number": "800-844-9302",
            "fax_number": "813-844-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12662 TELECOM DR",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370935",
            "telephone_number": "813-910-8708",
            "fax_number": "855-852-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "CHARLES",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME62847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "18235X",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371667800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.