Individual provider Active NPI

Jesse Vincent Dubey, D.O.

  • Emergency Medicine Physician
  • Tampa, FL
National Provider Identifier
1124361753
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
1124361753 Issued in FL
Practice address
12901 Bruce B Downs Blvd # 41
Tampa, FL 33612-4742
Phone
(813) 844-7412
NPI assigned
Apr 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 1124361753 FL Primary

Addresses

Primary practice location

12901 Bruce B Downs Blvd # 41
Tampa, FL 33612-4742

Mailing address

12901 Bruce B Downs Blvd # 41
Tampa, FL 33612-4742

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
I20160112000138 FL Practitioner - Emergency MedicinePractitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 1850693656 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1124361753FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Tampa After Hours Clinic, LLC CurrentSince Oct 8, 2015 Accepting new patients
Tampa Bay Emergency Physicians-Heartland LLC Emergency Medicine CurrentSince Mar 1, 2017 Accepting new patients
Florida Em-I Medical Services PA Emergency Medicine Past Accepting new patients

Locations

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

602 S Howard Ave
Tampa, FL 33606
Phone (813) 253-2113

735 S 5th Ave
Wauchula, FL 33873
Phone (863) 402-3402

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1124361753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD # 41",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD # 41",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742",
            "telephone_number": "813-844-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBEY",
        "first_name": "JESSE",
        "middle_name": "VINCENT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-02",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "1124361753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.