Michael Gene Niederbrach Jr.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME168138 Issued in FL

Practice address

1800 66TH St N Ste 210
St Petersburg, FL 33710-8747

Phone

(727) 893-6323

Fax

(727) 893-6324

NPI assigned

Apr 5, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health Bayfront Hospital Hospital, Saint Petersburg, FL, CCN 100032
• St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ohi West Medical Group, LLC

  dba Bayfront Health St. Petersburg Medical Group

  • Cardiovascular Disease Physician
  • St Petersburg, FL
  • NPI 1518572551

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Ohi West Medical Group, LLC

  dba Bayfront Health St. Petersburg Imaging Center

  • Radiology Clinic/Center
  • St Petersburg, FL
  • NPI 1285240192
  NPD
• Ohi West Medical Group, LLC

  dba Bayfront Health St. Petersburg Medical Group Urgent Care

  • Urgent Care Clinic/Center
  • St Petersburg, FL
  • NPI 1619583184
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ohi West, Inc

  dba Bayfront Health St Petersburg

  • General Acute Care Hospital
  • St Petersburg, FL
  • NPI 1154399749
  Care Compare affiliation
• St. Joseph's Hospital, Inc.

  dba St. Joseph's Women's Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1346519816
  Care Compare affiliation
• St. Joseph's Hospital, Inc.

  dba St. Joseph's Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1881632818
  Care Compare affiliation

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1083355846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 66TH ST N STE 210",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337108747",
            "telephone_number": "727-893-6323",
            "fax_number": "727-893-6324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 66TH ST N STE 210",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337108747",
            "telephone_number": "727-893-6323",
            "fax_number": "727-893-6324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 66th St N Ste 220",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337108747",
            "country_code": "US",
            "telephone_number": "727-893-6323",
            "fax_number": "727-893-6324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEDERBRACH",
        "first_name": "MICHAEL",
        "middle_name": "GENE",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME168138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126833700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Scott Nickerson, MS, ARNP-C, COHN-S
• Nicole Agresto, Psychology P.a.
• Krissle Nicome, APRN
• Abigail Grace Niebrugge, BCABA
• Michael Louis Nieder, M.D.
• Regan Elizabeth Niemann
• Erin Joan Nienke, APRN
• Thomas Nienke, DO
• Fawn Arlene Nieuwenhoff, ARNP
• Daime Del Carmen Nieves Munoz, APRN

• Family Medicine Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.