NPIMap

Organization Active NPI

Chapters Health Palliative Care, LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Temple Terrace, FL
National Provider Identifier
1073683553
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
CHAPTERS HEALTH PALLIATIVE CARE, LLC
Practice address
12470 Telecom Dr
Suite 300
Temple Terrace, FL 33637-0904
Phone
(813) 871-8200
Fax
(813) 871-8199
NPI assigned
Nov 9, 2006
Last updated
Aug 24, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
CHAPTERS HEALTH SYSTEM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Authorized official

Name
Crystal Bucciarelli
Title
Staff Attorney
Phone
(813) 871-8075

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X NU Primary

Addresses

Primary practice location

12470 Telecom Dr
Suite 300
Temple Terrace, FL 33637-0904

Mailing address

12470 Telecom Dr
Suite 300 - Attention: Compliance
Temple Terrace, FL 33637-0904
Phone (813) 871-8200

Other identifiers 16

IdentifierTypeStateIssuer
1609115534OtherPROVIDER - MATTHEW PETTIT APRN
1902134208OtherPROVIDER - ISABEL BALES APRN
1275872459OtherPROVIDER - JESSICA NOVAK APRN
1538669627OtherPROVIDER - RATCHADAKON TRAN APRN
1548294655OtherPROVIDER - MARY ALFONO TORRES MD
1376071415OtherPROVIDER - KERINE HINDS APRN
1437336302OtherPROVIDER - ZOE LEWIS MD
1720276157OtherPROVIDER - TERA GEARHART APRN
1003360058OtherPROVIDER - FITZWILLIAM MUSOKO ESELE APRN
1255758389OtherPROVIDER - JULIE MARTINEZ APRN
1083928592OtherPROVIDER - RAVI SAMLAL DO
1134156813OtherPROVIDER - ANDREA MILLER MD
1194037770OtherPROVIDER - ANTHONY JONES MD
1710428602OtherPROVIDER - JESSICA BAILES APRN
1144679176OtherPROVIDER - MARIBETH ALLEN APRN
1669622858OtherPROVIDER - KATHLEEN CURRAN APRN

Other names 1

  • Axis Palliative Healthcare, LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070913000741 FL Part B Supplier - Clinic/Group Practice 2163516733 Receives reassigned benefits from 68 practitioners
Practice locations: Tampa, FL; Winter Haven, FL; Trinity, FL; Temple Terrace, FL; New Port Richey, FL; Lutz, FL; Lakeland, FL; Lake Placid, FL…

National Provider Directory

National Provider Directory
Part of
Chapters Health System Inc

Locations

13601 Bruce B Downs Blvd
Ste 131
Tampa, FL 33613
Phone (813) 239-8246

5102 W Linebaugh Ave
Tampa, FL 33624
Phone (813) 440-6020

12470 Telecom Dr
Ste 300
Temple Terrace, FL 33637
Phone (813) 871-8111

12973 N Telecom Pkwy
Ste 101
Temple Terrace, FL 33637
Phone (813) 871-8111

Practitioners & affiliated clinicians

Practitioners 79

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.

View all 79

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598227200000",
    "number": "1073683553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12470 TELECOM DR",
            "address_2": "SUITE 300 - ATTENTION: COMPLIANCE",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370904",
            "telephone_number": "813-871-8200",
            "fax_number": "813-871-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12470 TELECOM DR",
            "address_2": "SUITE 300",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370904",
            "telephone_number": "813-871-8200",
            "fax_number": "813-871-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAPTERS HEALTH PALLIATIVE CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHAPTERS HEALTH SYSTEM, INC.",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-24",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "BUCCIARELLI",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "STAFF ATTORNEY",
        "authorized_official_telephone_number": "813-871-8075"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - MATTHEW PETTIT APRN",
            "identifier": "1609115534",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - ISABEL BALES APRN",
            "identifier": "1902134208",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - JESSICA NOVAK APRN",
            "identifier": "1275872459",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - RATCHADAKON TRAN APRN",
            "identifier": "1538669627",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - MARY ALFONO TORRES MD",
            "identifier": "1548294655",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - KERINE HINDS APRN",
            "identifier": "1376071415",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - ZOE LEWIS MD",
            "identifier": "1437336302",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - TERA GEARHART APRN",
            "identifier": "1720276157",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - FITZWILLIAM MUSOKO ESELE APRN",
            "identifier": "1003360058",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - JULIE MARTINEZ APRN",
            "identifier": "1255758389",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - RAVI SAMLAL DO",
            "identifier": "1083928592",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - ANDREA MILLER MD",
            "identifier": "1134156813",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - ANTHONY JONES MD",
            "identifier": "1194037770",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - JESSICA BAILES APRN",
            "identifier": "1710428602",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - MARIBETH  ALLEN APRN",
            "identifier": "1144679176",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER - KATHLEEN CURRAN APRN",
            "identifier": "1669622858",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Axis Palliative Healthcare, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Axis Palliative Healthcare, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Temple Terrace, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.