Individual provider Active NPI

Michael R Schoenberg, PHD

  • Clinical Neuropsychologist
  • Tampa, FL
National Provider Identifier
1073531463
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY7815 Issued in FL
Practice address
3515 E Fletcher Ave
Tampa, FL 33613-4706
Phone
(813) 974-8900
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 5956 OH
Psychologist 103T00000X PY7815 FL
Clinical Neuropsychologist 103G00000X PY7815 FL Primary

Addresses

Primary practice location

3515 E Fletcher Ave
Tampa, FL 33613-4706

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other identifiers 1

IdentifierTypeStateIssuer
75471OtherFLBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mschoenberg8552@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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081121000383 FL Practitioner - Clinical Psychologist 4284730755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Medical Service Association IncGroup PAC ID 6800790221, 818 clinicians

Practice addresses (Care Compare)

3515 E Fletcher Ave
MDC 14
Tampa, FL 33613-4706
Phone (813) 974-8900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY7815FLMDPsychologist
5956OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc CurrentSince Oct 4, 2008 Accepting new patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc CurrentSince Oct 4, 2008 Accepting new patients
University Neurologists Association,Inc Clinical Neuropsychologist Past Accepting new patients

Locations

3515 E Fletcher Ave
#14
Tampa, FL 33613
Phone (813) 974-8900

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

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

3515 E Fletcher Ave
Tampa, FL 33613
Phone (813) 974-2748

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: mschoenberg8552@direct.tgh.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1073531463",
    "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": "3515 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134706",
            "telephone_number": "813-974-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENBERG",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OH",
            "license": "5956",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY7815",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY7815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "75471",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mschoenberg8552@direct.tgh.org",
            "affiliation": "N",
            "address_1": "3515 E Fletcher Ave",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336134706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.