NPIMap

Individual provider Active NPI

Belen M. Herrero-Mujic, MD

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1114959046
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME79160 Issued in FL
Practice address
17417 Bridgehill CT.
Tampa, FL 33647-2308
Phone
(813) 972-7900
Fax
(813) 355-5035
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME79160 FL Primary

Addresses

Primary practice location

17417 Bridgehill CT.
Tampa, FL 33647-2308

Mailing address

38135 Market SQ
Zephyrhills, FL 33542-7505
Phone (813) 528-4975

Other identifiers 2

IdentifierTypeStateIssuer
P00167549OtherFLRR MEDICARE
260875800MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address imt@flmed.directbygreenway.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040831000492 FL Practitioner - Internal Medicine 9335114651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Florida College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

17417 Bridge Hill CT
Tampa, FL 33647-3467
Phone (813) 972-7900

17470 Brookside Trace CT
Tampa, FL 33647-6201
Phone (813) 443-5042

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME79160FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Clinic, LLC CurrentSince Jun 1, 2004 Accepting new patients
Ohi West Medical Group II LLC Internal Medicine CurrentSince Jun 17, 2024 Accepting new patients
Ohi West Medical Group II LLC CurrentSince Jun 17, 2024 Accepting new patients
Florida Medical Clinic LLC CurrentSince Jun 1, 2004 Accepting new patients
Ohi West Medical Group II LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

17417 Bridge Hill Ct
Tampa, FL 33647
Phone (813) 972-7900

15303 Amberly Dr
Ste A
Tampa, FL 33647
Phone (813) 712-5700

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

Organizations & group practices 6

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 9

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1114959046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "813-528-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17417 BRIDGEHILL CT.",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472308",
            "telephone_number": "813-972-7900",
            "fax_number": "813-355-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERO-MUJIC",
        "first_name": "BELEN",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME79160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00167549",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260875800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "imt@flmed.directbygreenway.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "17417 Bridgehill Ct.",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336472308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.