NPIMap

Organization Active NPI

Tampa Institute for Pain and Spine, LLC

  • Interventional Pain Medicine Physician
  • Riverview, FL
National Provider Identifier
1134571128
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
TAMPA INSTITUTE FOR PAIN AND SPINE, LLC
Practice address
13140 Elk Mountain Dr
Suite B
Riverview, FL 33579
Phone
(813) 513-8477
NPI assigned
Jul 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Authorized official

Name
Jessen Mukalel, M.D.
Title
President
Phone
(813) 513-8477

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

13140 Elk Mountain Dr
Suite B
Riverview, FL 33579

Mailing address

13140 Elk Mountain Dr
Suite B
Riverview, FL 33579-7182
Phone (813) 513-8477

Other identifiers 1

IdentifierTypeStateIssuer
18353700MedicaidFL

National Provider Directory

National Provider Directory

Locations

13140 Elk Mountain Dr
Ste B
Riverview, FL 33579
Phone (813) 513-8477

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532995200000",
    "number": "1134571128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13140 ELK MOUNTAIN DR",
            "address_2": "SUITE B",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335797182",
            "telephone_number": "813-513-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13140 ELK MOUNTAIN DR",
            "address_2": "SUITE B",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "33579",
            "telephone_number": "813-513-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA INSTITUTE FOR PAIN AND SPINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-01",
        "last_updated": "2018-07-31",
        "status": "A",
        "authorized_official_last_name": "MUKALEL",
        "authorized_official_first_name": "JESSEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-513-8477",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18353700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.