Individual provider Active NPI

Denise Ferhat Feradov, MD

  • Cardiovascular Disease Physician
  • Tampa, FL
National Provider Identifier
1063944882
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME145370 Issued in FL
Practice address
17 Davis Blvd
Suite 308
Tampa, FL 33606-3475
Phone
(813) 259-0661
NPI assigned
Mar 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME145370 FL Primary

Addresses

Primary practice location

17 Davis Blvd
Suite 308
Tampa, FL 33606-3475

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other practice location 1

2 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 821-8038

Other identifiers 2

IdentifierTypeStateIssuer
OCIZIOtherFLBCBS
123116400MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dferadov175244@direct.tgh.org

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
I20240723001797 FL Practitioner - Cardiovascular Disease (Cardiology) 8527504802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Univ of Central Florida, College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12901 Bruce B Downs Blvd
Tampa, FL 33612-4742
Phone (813) 821-8038

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (813) 821-8038

13330 Usf Laurel Dr
Tampa, FL 33612-6601

4202 E Fowler Ave
Tampa, FL 33620-6750

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME145370FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc CurrentSince Jul 11, 2024 Accepting new patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince Jul 11, 2024 Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

2 Tampa General Cir
Tampa, FL 33606
Phone (813) 259-8700

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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 6

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1063944882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 DAVIS BLVD",
            "address_2": "SUITE 308",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063475",
            "telephone_number": "813-259-0661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063571",
            "country_code": "US",
            "telephone_number": "813-821-8038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERADOV",
        "first_name": "DENISE",
        "middle_name": "FERHAT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME145370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "OCIZI",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123116400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dferadov175244@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.