NPIMap

Individual provider Active NPI

Daniel M Conrado, MD

  • General Practice Physician
  • Pinellas Park, FL
National Provider Identifier
1114910221
Registry record updated Apr 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME0024802 Issued in FL
Practice address
4423 Park Blvd N
Pinellas Park, FL 33781-3540
Phone
(727) 827-2825
Fax
(727) 827-2809
NPI assigned
Aug 24, 2005
Last updated
Apr 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME0024802 FL Primary

Addresses

Primary practice location

4423 Park Blvd N
Pinellas Park, FL 33781-3540

Mailing address

4423 Park Blvd N
Pinellas Park, FL 33781-3540
Phone (727) 827-2825

Other identifiers 2

IdentifierTypeStateIssuer
52941OtherBCBS
52941XOtherTRICARE

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Center LLC Past Accepting new patients
LBH Med Group LLC PastSince Mar 1, 2015 Accepting new patients
Trinity Physicians, LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430179200000",
    "number": "1114910221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4423 PARK BLVD N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813540",
            "telephone_number": "727-827-2825",
            "fax_number": "727-827-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4423 PARK BLVD N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813540",
            "telephone_number": "727-827-2825",
            "fax_number": "727-827-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRADO",
        "first_name": "DANIEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2015-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME0024802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52941",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "52941X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.