Individual provider Active NPI

Tammy C D'Souza, DO

  • Adult Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1083652598
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
OS13362 Issued in FL
Practice address
701 Union St
Kissimmee, FL 34741-5007
Phone
(407) 518-5004
Fax
(407) 643-9343
NPI assigned
Jun 4, 2006
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X OS13362 FL Primary
Family Medicine Physician 207Q00000X OS13362 FL
Family Medicine Physician 207Q00000X OP00001702 WA

Addresses

Primary practice location

701 Union St
Kissimmee, FL 34741-5007

Mailing address

701 Union St
Kissimmee, FL 34741-5007
Phone (407) 518-5004

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tammy.d'souza@va.gov Direct

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
I20151015002292 FL Practitioner - Family Practice 4486783347 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS13362FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Regional Health Systems, Inc. CurrentSince Nov 1, 2015 Accepting new patients
Lakeland Regional Medical Center, Inc. Past Accepting new patients
Good Samaritan Community Healthcare Family Medicine PastSince Jul 15, 2003 Accepting new patients

Locations

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

1324 Lakeland Hills Blvd
Ofc
Lakeland, FL 33805
Phone (863) 687-1177

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

430 E Central Ave
Winter Haven, FL 33880
Phone (863) 284-5061

Interoperability endpoints

  • Direct secure messaging: tdsouza17490@lrhs.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1083652598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 UNION ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415007",
            "telephone_number": "407-518-5004",
            "fax_number": "407-643-9343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 UNION ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415007",
            "telephone_number": "407-518-5004",
            "fax_number": "407-643-9343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'SOUZA",
        "first_name": "TAMMY",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "OS13362",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS13362",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00001702",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tammy.d'souza@va.gov",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "701 Union St",
            "city": "Kissimmee",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347415007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.