Individual provider Active NPI

Eman Kalboush, MD

  • Diagnostic Radiology Physician
  • Tampa, FL
National Provider Identifier
1104489848
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME154385 Issued in FL
Practice address
17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Phone
(813) 844-7000
NPI assigned
Apr 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME154385 FL Primary

Addresses

Primary practice location

17 Davis Blvd Ste 308
Tampa, FL 33606-3438

Mailing address

17 Davis Blvd Ste 308
Tampa, FL 33606-3438

Other practice location 1

3402 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6214
Phone (813) 875-3950

Other practice location 2

403 S Kings Ave Ste 100
Brandon, FL 33511-5962
Phone (813) 982-3460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200831001212 FL Practitioner - Diagnostic Radiology 7315364775 Reassigns benefits to 3 organizations
I20241118000578 VA Practitioner - Diagnostic Radiology 7315364775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Practice addresses (Care Compare)

1000 W Horatio St
Apt 114
Tampa, FL 33606-2656
Phone (904) 399-5550

12028 Ivy Hollow CT
Glen Allen, VA 23059-7531
Phone (904) 399-5550

141 Westbury
Williamsburg, VA 23188-8912
Phone (866) 722-1655

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 399-5550

6224 Salisbury Dr
Spotsylvania, VA 22553-4475
Phone (904) 399-5550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.22 of 100Reported as group
Quality
95.56
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC Diagnostic Radiology CurrentSince May 1, 2023 Accepting new patients
Tampa General Hospital Current Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Tower Imaging LLC Diagnostic Radiology CurrentSince Jan 1, 2022 Accepting new patients

Locations

427 S Parsons Ave
Ste 100
Brandon, FL 33511
Phone (813) 215-2080

3350 Bell Shoals Rd
Brandon, FL 33511
Phone (813) 654-4883

403 S Kings Ave
Ste 100
Brandon, FL 33511
Phone (813) 982-3460

5539 Marine Pkwy
New Pt Richey, FL 34652
Phone (727) 841-8225

3870 Tampa Rd
Oldsmar, FL 34677
Phone (352) 795-5628

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

7525 State Road 52
Port Richey, FL 34667
Phone (727) 847-5122

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

3862 Sun City Center Blvd
Sun City Center, FL 33573
Phone (813) 642-9299

4719 N Habana Ave
Tampa, FL 33614
Phone (813) 874-9769

2106 S Lois Ave
Tampa, FL 33629
Phone (813) 287-1191

3402 W Mlk Blvd
Tampa, FL 33607
Phone (813) 875-3950

3402 W Dr Martin Luther King Jr Blvd
Fl Cancer
Tampa, FL 33607
Phone (813) 875-3950

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: ekalboush154465@direct.tgh.org

Organizations & group practices 5

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 3

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": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1104489848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 DAVIS BLVD STE 308",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 DAVIS BLVD STE 308",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063438",
            "telephone_number": "813-844-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3402 W Dr Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076214",
            "country_code": "US",
            "telephone_number": "813-875-3950",
            "fax_number": "813-872-2741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "403 S Kings Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115962",
            "country_code": "US",
            "telephone_number": "813-982-3460",
            "fax_number": "813-982-3461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALBOUSH",
        "first_name": "EMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME154385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.