Individual provider Active NPI

Kathryn Dasburg, MD

  • Emergency Medicine Physician
  • Saint Petersburg, FL
National Provider Identifier
1104313089
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME157519 Issued in FL
Practice address
701 6TH St S
Saint Petersburg, FL 33701-4814
Phone
(727) 823-1234
NPI assigned
Apr 17, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME157519 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

701 6TH St S
Saint Petersburg, FL 33701-4814

Mailing address

603 7TH St S Ste 360
Saint Petersburg, FL 33701-4732

Other practice location 1

1515 SW Archer Rd
Gainesville, FL 32608-1134
Phone (612) 839-0528

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
I20220824003042 FL Practitioner - Emergency Medicine 1658624002 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Florida International Univ, College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Emergency Physician Services of South Dade, Inc 41 clinicians

Practice addresses (Care Compare)

8900 N Kendall Dr
Miami, FL 33176-2118
Phone (954) 939-5000

Hospital & facility affiliations

  • Baptist Hospital of Miami Hospital, Miami, FL, CCN 100008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME157519FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Crossroads Emergency Medicine CurrentSince May 7, 2023 Accepting new patients
Sheridan Emergency Physician Services of South Dade Inc Emergency Medicine CurrentSince Dec 17, 2022 Accepting new patients
Emergency Physicians of Pinellas PA Emergency Medicine CurrentSince Sep 15, 2022 Accepting new patients
Emergency Physicians of St Petersburg PA Emergency Medicine CurrentSince Sep 15, 2022 Accepting new patients

Locations

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

3070 Grand Ave
Pinellas Park, FL 33782
Phone (727) 553-7300

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

603 7th St S
Ste 360
St Petersburg, FL 33701
Phone (727) 553-7300

Organizations & group practices 4

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 1

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": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1104313089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 7TH ST S STE 360",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337014732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 6TH ST S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337014814",
            "telephone_number": "727-823-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326081134",
            "country_code": "US",
            "telephone_number": "612-839-0528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DASBURG",
        "first_name": "KATHRYN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME157519",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

Verify at the official NPI Registry.