Individual provider Active NPI

Michael K Coleman, M.D.

  • Physical Medicine & Rehabilitation Physician
  • St Petersburg, FL
National Provider Identifier
1164590428
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME72963 Issued in FL
Practice address
1839 Central Ave.
St Petersburg, FL 33713-8900
Phone
(727) 322-1054
Fax
(727) 821-7213
NPI assigned
Dec 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME72963 FL Primary

Addresses

Primary practice location

1839 Central Ave.
St Petersburg, FL 33713-8900

Mailing address

1839 Central Ave.
St Petersburg, FL 33713-8900
Phone (727) 322-1054

Other identifiers 1

IdentifierTypeStateIssuer
001051700MedicaidFL

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
I20080301000018 FL Practitioner - Physical Medicine and Rehabilitation 2567546419 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Health Care of Pinellas, LLCGroup PAC ID 1658274675, 88 clinicians

Practice addresses (Care Compare)

1839 Central Ave
St Petersburg, FL 33713-9089
Phone (727) 322-1054

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Health Care of Pinellas LLC CurrentSince Aug 1, 2018 Accepting new patients
Comprehensive Hospital Physicians of Florida Inc CurrentSince Mar 1, 2024 Accepting new patients
Professional Health Care of Pinellas Inc. CurrentSince Aug 1, 2018 Accepting new patients
QMC LLC Past Accepting new patients

Locations

6020 Indiana Ave
New Prt Rchy, FL 34653
Phone (352) 860-0200

1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054

7101 Mlk Jr St N
St Petersburg, FL 33702
Phone (727) 527-7231

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA
  • Direct secure messaging: michael.coleman@phcopi.eclinicaldirectplus.com

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": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1164590428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE.",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-821-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE.",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-821-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME72963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001051700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.