Individual provider Active NPI

Jaspreet Kaur Pestana, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Tampa, FL
National Provider Identifier
1154402816
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
ME96774 Issued in FL
Practice address
4001 E Fletcher Ave
Tampa, FL 33613
Phone
(813) 974-2201
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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 ME96774 FL Primary

Addresses

Primary practice location

4001 E Fletcher Ave
Tampa, FL 33613

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other practice location 1

401 Chandler Rd
Greer, SC 29651-1243
Phone (828) 277-4810

Other names 1

  • Dr. Jaspreet Kaur Bhullar Former name

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
I20070926001117 FL Practitioner - Geriatric MedicinePractitioner - Internal Medicine 8022103787 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc CurrentSince Feb 22, 2019 Accepting new patients
University Medical Service Association Inc CurrentSince Feb 22, 2019 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
Elias Kanaan MD PA PastSince Aug 20, 2001 Accepting new patients

Locations

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

4001 E Fletcher Ave
Tampa, FL 33613
Phone (813) 866-1600

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADDJAA

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1154402816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33613",
            "telephone_number": "813-974-2201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Chandler Rd",
            "address_purpose": "LOCATION",
            "city": "Greer",
            "state": "SC",
            "postal_code": "296511243",
            "country_code": "US",
            "telephone_number": "828-277-4810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PESTANA",
        "first_name": "JASPREET",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME96774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASPREET",
            "last_name": "BHULLAR",
            "middle_name": "KAUR",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.