Active NPI
Ismail Kazem, M.D.
- Therapeutic Radiology Physician
- Tampa, FL
National Provider Identifier
1083705156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Therapeutic Radiology Physician
- License
- ME87095
- Practice address
- 13000 Bruce B Downs Blvd
Tampa, FL 33612-4745 - Phone
- (813) 972-7667
- Fax
- (813) 978-5805
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Therapeutic Radiology Physician | 2085R0203X | ME87095 | FL | Primary |
Addresses
Primary practice location
13000 Bruce B Downs Blvd
Tampa, FL 33612-4745
Mailing address
19103 Marisa Ridge PL
Tampa, FL 33647-3606
Phone (813) 972-7667
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME87095 | FL | MD | Therapeutic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083705156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19103 MARISA RIDGE PL",
"city": "TAMPA",
"state": "FL",
"postal_code": "336473606",
"telephone_number": "813-972-7667",
"fax_number": "813-978-5805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13000 BRUCE B DOWNS BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336124745",
"telephone_number": "813-972-7667",
"fax_number": "813-978-5805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAZEM",
"first_name": "ISMAIL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0203X",
"taxonomy_group": "",
"desc": "Radiology, Therapeutic Radiology",
"state": "FL",
"license": "ME87095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.