NPIMap

Individual provider Active NPI

Michelle Annette Osorio Acevedo, MD

  • Nephrology Physician
  • St Petersburg, FL
National Provider Identifier
1083108146
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
154463 Issued in FL
Practice address
635 4TH St N Ste 200
St Petersburg, FL 33701-2319
Phone
(727) 201-4968
Fax
(727) 201-4971
NPI assigned
Jun 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 154463 FL
General Practice Physician 208D00000X 21854 PR
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 154463 FL Primary

Addresses

Primary practice location

635 4TH St N Ste 200
St Petersburg, FL 33701-2319

Mailing address

10800 Brighton Bay Blvd NE Apt 12207
St Petersburg, FL 33716-3479
Phone (727) 688-2982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230412002372 FL Practitioner - Nephrology 0446625008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
National Kidney Partners LLPGroup PAC ID 7012981350, 63 clinicians

Practice addresses (Care Compare)

635 4TH St N
Suite 200
Saint Petersburg, FL 33701-2319
Phone (727) 201-4968

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
154463FLMDInternal Medicine Physician
21854PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
National Kidney Partners, LLP Single Specialty CurrentSince Mar 27, 2023 Accepting new patients

Locations

14134 Nephron Ln
Hudson, FL 34667
Phone (727) 863-5418

635 4th St N
Ste 200
St Petersburg, FL 33701
Phone (727) 201-4968

2191 9th Ave N
Ste 200
St Petersburg, FL 33713
Phone (727) 327-0990

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mosorioacevedo77181@direct.acumenmd.com

Organizations & group practices 1

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 9

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": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1083108146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 BRIGHTON BAY BLVD NE APT 12207",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337163479",
            "telephone_number": "727-688-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 4TH ST N STE 200",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337012319",
            "telephone_number": "727-201-4968",
            "fax_number": "727-201-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSORIO ACEVEDO",
        "first_name": "MICHELLE",
        "middle_name": "ANNETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "154463",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21854",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "154463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.