NPIMap

Organization Active NPI

Tampa Bay Emergency Physicians LLC

  • Emergency Medicine Physician
  • Tampa, FL
National Provider Identifier
1114977428
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
TAMPA BAY EMERGENCY PHYSICIANS LLC
Practice address
3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone
(330) 493-4443
Fax
(813) 615-7590
NPI assigned
May 10, 2006
Last updated
Oct 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Authorized official

Name
Brian M Baker, MBANPI 1346293834
Title
Executive Director
Phone
(330) 493-4443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

3100 E Fletcher Ave
Tampa, FL 33613-4613

Mailing address

12479 Telecom Dr
Tampa, FL 33637-0913
Phone (330) 493-4443

Other identifiers 5

IdentifierTypeStateIssuer
262772804MedicaidFL
262772800MedicaidFL
262772803MedicaidFL
45981OtherFLBCBS OF FLORIDA
262772801MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051206000518 FL Part B Supplier - Clinic/Group Practice 0345260345 Receives reassigned benefits from 310 practitioners
Practice locations: Tampa, FL; Zephyrhills, FL; Wesley Chapel, FL; Tarpon Springs, FL; Brandon, FL; Dade City, FL; Palm Harbor, FL; Lutz, FL

National Provider Directory

National Provider Directory

Locations

305 E Brandon Blvd
Brandon, FL 33511
Phone (813) 548-8600

16625 State Road 54
Lutz, FL 33558
Phone (813) 328-4999

34106 US Highway 19 N
Palm Harbor, FL 34684
Phone (727) 401-3900

12479 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 972-4199

Practitioners & affiliated clinicians

Practitioners 338

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 338

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475625600000",
    "number": "1114977428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12479 TELECOM DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336370913",
            "telephone_number": "330-493-4443",
            "fax_number": "813-972-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134613",
            "telephone_number": "330-493-4443",
            "fax_number": "813-615-7590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA BAY EMERGENCY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2016-10-05",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "330-493-4443",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262772804",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262772800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262772803",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "45981",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262772801",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.