Individual provider Active NPI

William Paul Krockta, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Tampa, FL
National Provider Identifier
1114963444
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
ME47596 Issued in FL
Practice address
10905 Cliff Dr
Tampa, FL 33617-3202
Phone
(813) 681-0665
Fax
(813) 914-7473
NPI assigned
Jun 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME47596 FL Primary

Addresses

Primary practice location

10905 Cliff Dr
Tampa, FL 33617-3202

Mailing address

PO Box 290615
Tampa, FL 33687-0615
Phone (813) 681-0665

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
I20100616000032 FL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 9830225739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
State University of Ny Upstate Medical University, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
V.J. Dilella, D.O., L.L.C.Group PAC ID 1951208057, 11 clinicians

Practice addresses (Care Compare)

703 Virginia St
Dunedin, FL 34698-6615
Phone (727) 734-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
V.J. Dilella, D.O., L.L.C. CurrentSince Jun 1, 2021 Accepting new patients
Mobile Physician Services Inc. Past Accepting new patients
Hospice and Palliative Physician Services, LLC PastSince Dec 1, 2007 Accepting new patients

Locations

703 Virginia St
Dunedin, FL 34698
Phone (727) 734-4000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114963444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290615",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336870615",
            "telephone_number": "813-681-0665",
            "fax_number": "813-914-7473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10905 CLIFF DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336173202",
            "telephone_number": "813-681-0665",
            "fax_number": "813-914-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROCKTA",
        "first_name": "WILLIAM",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME47596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.