Individual provider Active NPI

Therese K Kossuth, PA-C

  • Medical Physician Assistant
  • Palm Harbor, FL
National Provider Identifier
1164469094
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
FL2558 Issued in FL
Practice address
2851 Tampa Rd
Palm Harbor, FL 34684-3314
Phone
(872) 231-3162
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X FL2558 FL Primary

Addresses

Primary practice location

2851 Tampa Rd
Palm Harbor, FL 34684-3314

Mailing address

PO Box 7410884
Chicago, IL 60674-0884
Phone (702) 899-0595

Other practice location 1

5350 Spring Hill Dr
Spring Hill, FL 34606-4562
Phone (352) 688-8116

Other identifiers 1

IdentifierTypeStateIssuer
2916177 00MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060113000627 FL Practitioner - Physician Assistant 2668495854 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
FL2558FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Sciences Center Inc CurrentSince Sep 15, 2025 Accepting new patients
Tampa General Hospital Current Accepting new patients
Qed Medical Solutions, LLC Past Accepting new patients
U.S. Healthworks Medical Group of Florida, Inc. Past Accepting new patients

Locations

5802 N 30th St
Tampa, FL 33610
Phone (813) 236-5100

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: tkossuth324319@direct.tgh.org

Organizations & group practices 5

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1164469094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7410884",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740884",
            "telephone_number": "702-899-0595",
            "fax_number": "702-977-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 TAMPA RD",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843314",
            "telephone_number": "872-231-3162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5350 Spring Hill Dr",
            "address_purpose": "LOCATION",
            "city": "Spring Hill",
            "state": "FL",
            "postal_code": "346064562",
            "country_code": "US",
            "telephone_number": "352-688-8116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSSUTH",
        "first_name": "THERESE",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "FL2558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2916177 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.