Individual provider Active NPI

John Thomas Masiello, MD

  • Anesthesiology Physician
  • Brandon, FL
National Provider Identifier
1104895390
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME75034 Issued in FL
Practice address
711 S Parsons Ave
Brandon, FL 33511-6058
Phone
(913) 754-0467
Fax
(913) 341-5797
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME75034 FL Primary

Addresses

Primary practice location

711 S Parsons Ave
Brandon, FL 33511-6058

Mailing address

PO Box 862811
Orlando, FL 32886-2811
Phone (913) 754-0467

Other identifiers 3

IdentifierTypeStateIssuer
050066602OtherFLRAILROAD MEDICARE
254304400MedicaidFL
43374OtherFLBCBS

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
I20040913000243 FL Practitioner - Anesthesiology 6204803026 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME75034FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC Anesthesiology CurrentSince Jan 1, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Anesthesiology CurrentSince Jan 1, 2020 Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

711 S Parsons Ave
Brandon, FL 33511
Phone (813) 654-7111

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1104895390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 862811",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328862811",
            "telephone_number": "913-754-0467",
            "fax_number": "913-341-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S PARSONS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116058",
            "telephone_number": "913-754-0467",
            "fax_number": "913-341-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASIELLO",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME75034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050066602",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254304400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "43374",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.