Organization Active NPI

Parkinsons &Neurology Clinic LLC

  • Neurology Physician
  • Temple Terrace, FL
National Provider Identifier
1093416653
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
PARKINSONS &NEUROLOGY CLINIC LLC
Practice address
11700 N 58TH St
Temple Terrace, FL 33617-1666
Phone
(813) 690-6144
Fax
(813) 980-0303
NPI assigned
Mar 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Israt Jahan, MDNPI 1447637129
Title
Director
Phone
(813) 451-7431

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

11700 N 58TH St
Temple Terrace, FL 33617-1666

Mailing address

20248 Merry Oak Ave
Tampa, FL 33647-3642
Phone (813) 451-7431

Other practice location 1

8701 49th St N
Pinellas Park, FL 33782-5331
Phone (727) 546-4661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230707000417 FL Part B Supplier - Clinic/Group Practice 2264891324 Receives reassigned benefits from 1 practitioner
Practice locations: Bradenton, FL; Wesley Chapel, FL; St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

2010 59th St W
Ste 3800
Bradenton, FL 34209
Phone (727) 313-7679

2299 9th Ave N
Ste 3D
St Petersburg, FL 33713
Phone (727) 313-7679

11700 N 58th St
Temple Terrace, FL 33617
Phone (813) 690-6144

27453 Cashford Cir
Ste 101
Wesley Chapel, FL 33544
Phone (727) 313-7679

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1093416653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20248 MERRY OAK AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473642",
            "telephone_number": "813-451-7431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 N 58TH ST",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336171666",
            "telephone_number": "813-690-6144",
            "fax_number": "813-980-0303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8701 49th St N",
            "address_purpose": "LOCATION",
            "city": "Pinellas Park",
            "state": "FL",
            "postal_code": "337825331",
            "country_code": "US",
            "telephone_number": "727-546-4661",
            "fax_number": "727-545-8783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PARKINSONS &NEUROLOGY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "JAHAN",
        "authorized_official_first_name": "ISRAT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "813-451-7431",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.