Individual provider Active NPI

Erica Elizabeth Elseed Peterson, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Tampa, FL
National Provider Identifier
1083078158
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
ME140498 Issued in FL
Practice address
17 Davis Blvd
Suite 208
Tampa, FL 33606-3475
Phone
(813) 259-0998
NPI assigned
Apr 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X ME140498 FL Primary

Addresses

Primary practice location

17 Davis Blvd
Suite 208
Tampa, FL 33606-3475

Mailing address

PO Box 917770
Orlando, FL 32891-0001
Phone (813) 821-8038

Other practice location 1

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

Other identifiers 2

IdentifierTypeStateIssuer
115073900MedicaidFL
ARFMNOtherFLBLUE CROSS BLUE SHIELD

Other names 1

  • Erica Elizabeth Elseed Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address epetereson92104@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
I20220815001962 FL Practitioner - Pediatric Medicine 5092198697 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince Jul 12, 2022 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc CurrentSince Jul 12, 2022 Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

17 Davis Blvd
Ste 208
Tampa, FL 33606
Phone (813) 259-0998

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

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

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

Interoperability endpoints

  • Direct secure messaging: epeterson92104@direct.tgh.org
  • Direct secure messaging: epetereson92104@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: epeterson733851@direct.hopkinsmedicine.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": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1083078158",
    "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",
            "telephone_number": "813-821-8038",
            "fax_number": "813-974-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 DAVIS BLVD",
            "address_2": "SUITE 208",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063475",
            "telephone_number": "813-259-0998"
        }
    ],
    "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",
            "fax_number": "813-974-4325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ERICA",
        "middle_name": "ELIZABETH ELSEED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-05",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "FL",
            "license": "ME140498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115073900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "ARFMN",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "epetereson92104@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": [
        {
            "first_name": "ERICA",
            "last_name": "ELSEED",
            "middle_name": "ELIZABETH",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.