Individual provider Active NPI

Timothy Zack Day, PA-C

  • Surgical Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1033567839
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9113305 Issued in FL
Practice address
603 7TH St S Ste 500
St Petersburg, FL 33701-4734
Phone
(727) 893-6435
Fax
(727) 893-6436
NPI assigned
Jun 2, 2016
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA058160 PA
Surgical Physician Assistant 363AS0400X PA9113305 FL Primary

Addresses

Primary practice location

603 7TH St S Ste 500
St Petersburg, FL 33701-4734

Mailing address

603 7TH St S Ste 500
St Petersburg, FL 33701-4734
Phone (727) 893-6254

Other practice location 1

897 Poplar Rd
Camp HIll, PA 17011
Phone (717) 857-0010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171206002129 CT Practitioner - Physician Assistant 8729370713 Reassigns benefits to 4 organizations
I20201214002251 FL Practitioner - Physician Assistant 8729370713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

603 7TH St S
Suite 500
St Petersburg, FL 33701-4734
Phone (727) 893-6254

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA058160PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc Physician Assistant CurrentSince Nov 1, 2017 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Hartford Hospital CurrentSince Nov 1, 2017 Accepting new patients
William W Backus Hospital CurrentSince Jun 1, 2019 Accepting new patients
Hartford Hospital CurrentSince Nov 1, 2017 Accepting new patients
Hartford Hospital CurrentSince Nov 1, 2017 Accepting new patients

Locations

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: tday403201@orlandohealth.medalliesdirect.net

Organizations & group practices 8

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.

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": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1033567839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 7TH ST S STE 500",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014734",
            "telephone_number": "727-893-6254",
            "fax_number": "727-553-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 7TH ST S STE 500",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014734",
            "telephone_number": "727-893-6435",
            "fax_number": "727-893-6436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "897 Poplar Rd",
            "address_purpose": "LOCATION",
            "city": "Camp HIll",
            "state": "PA",
            "postal_code": "17011",
            "country_code": "US",
            "telephone_number": "717-857-0010",
            "fax_number": "717-857-0011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAY",
        "first_name": "TIMOTHY",
        "middle_name": "ZACK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-02",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058160",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9113305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.