Individual provider Active NPI

Maritess Garcia Dejesus, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • New Port Richey, FL
National Provider Identifier
1083680722
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME54869 Issued in FL
Practice address
5950 High St
New Port Richey, FL 34652
Phone
(727) 842-4848
Fax
(727) 842-9513
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME54869 FL Primary

Addresses

Primary practice location

5950 High St
New Port Richey, FL 34652

Mailing address

5950 High St
New Port Richey, FL 34652
Phone (727) 842-4848

Other identifiers 1

IdentifierTypeStateIssuer
051285100MedicaidFL

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
I20060110000624 FL Practitioner - Pathology 7315960929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Regional Laboratories Pathology Services, LLCGroup PAC ID 9133244346, 132 clinicians

Practice addresses (Care Compare)

9330 State Rd
Suite 54
Trinity, FL 34655-1808
Phone 72783440004875

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Regional Laboratories Pathology Services, LLC Anatomic Pathology & Clinical Pathology CurrentSince Jan 2, 2015 Accepting new patients
Smith Winquist & Associates MD PA Anatomic Pathology & Clinical Pathology Current Accepting new patients

Locations

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

5950 High St
New Prt Rchy, FL 34652
Phone (727) 842-4848

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

11375 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 596-4209

Organizations & group practices 2

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 4

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1083680722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5950 HIGH ST",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "34652",
            "telephone_number": "727-842-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 HIGH ST",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "34652",
            "telephone_number": "727-842-4848",
            "fax_number": "727-842-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "MARITESS",
        "middle_name": "GARCIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME54869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051285100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.