Individual provider Active NPI

Abduljabbar Al Tekreeti, MD

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1043503436
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME126405 Issued in FL
Practice address
3901 Coconut Palm Dr Ste 120
Tampa, FL 33619-8362
Phone
(813) 289-6597
Fax
(865) 769-3454
NPI assigned
May 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X IL
Internal Medicine Physician 207R00000X ME126405 FL Primary

Addresses

Primary practice location

3901 Coconut Palm Dr Ste 120
Tampa, FL 33619-8362

Mailing address

3901 Coconut Palm Dr Ste 120
Tampa, FL 33619-8362
Phone (813) 289-6597

Other identifiers 1

IdentifierTypeStateIssuer
1043503436MedicaidFL

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
I20161115001934 FL Practitioner - Internal Medicine 5799064796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1431 SW 1St Ave
Ocala, FL 34471-6500
Phone (352) 401-1000

3030 W Bearss Ave
Tampa, FL 33618-1811
Phone (813) 968-8777

4600 SW
46TH BLDG 200
Ocala, FL 34474-5783
Phone (352) 291-3000

4600 SW 46TH CT
Ocala, FL 34474-5783
Phone (352) 291-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME126405FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients

Locations

2029 Professional Center Dr
Orange Park, FL 32073
Phone (570) 352-3063

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3901 Coconut Palm Dr
Ste 120
Tampa, FL 33619
Phone (813) 289-6597

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Organizations & group practices 2

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": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1043503436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 COCONUT PALM DR STE 120",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336198362",
            "telephone_number": "813-289-6597",
            "fax_number": "865-769-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 COCONUT PALM DR STE 120",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336198362",
            "telephone_number": "813-289-6597",
            "fax_number": "865-769-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL TEKREETI",
        "first_name": "ABDULJABBAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME126405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043503436",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.