NPIMap

Organization Active NPI

Polmed PA

  • Internal Medicine Physician
  • Palm Harbor, FL
National Provider Identifier
1033144290
Registry record updated Jan 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
POLMED PA
Practice address
3890 Tampa Rd Ste 404
Palm Harbor, FL 34684-3675
Phone
(727) 216-0505
Fax
(727) 789-8261
NPI assigned
Jul 12, 2006
Last updated
Jan 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2010

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

Authorized official

Name
Robert Kaszuba, MDNPI 1841277225
Title
President
Phone
(727) 216-0505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

3890 Tampa Rd Ste 404
Palm Harbor, FL 34684-3675

Mailing address

3890 Tampa Rd Ste 404
Palm Harbor, FL 34684-3675
Phone (727) 216-0505

Other identifiers 1

IdentifierTypeStateIssuer
274663800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060317000514 FL Part B Supplier - Clinic/Group Practice 2961419874 Receives reassigned benefits from 6 practitioners
Practice locations: Safety Harbor, FL

National Provider Directory

National Provider Directory

Locations

3890 Tampa Rd
Ste 404
Palm Harbor, FL 34684
Phone (727) 216-0505

1803 Briar Creek Blvd
Safety Harbor, FL 34695
Phone (727) 216-0505

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1033144290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 TAMPA RD STE 404",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843675",
            "telephone_number": "727-216-0505",
            "fax_number": "727-789-8261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 TAMPA RD STE 404",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843675",
            "telephone_number": "727-216-0505",
            "fax_number": "727-789-8261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLMED PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2010-01-12",
        "status": "A",
        "authorized_official_last_name": "KASZUBA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-216-0505",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274663800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.