Individual provider Active NPI

Martin P. Iwanowski, DO

  • Emergency Medicine Physician
  • Clearwater, FL
National Provider Identifier
1164837688
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
6817 Issued in GA
Practice address
300 Pinellas St # Ms -36
Clearwater, FL 33756-3804
Phone
(727) 298-6612
NPI assigned
Jun 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 6817 GA Primary

Addresses

Primary practice location

300 Pinellas St # Ms -36
Clearwater, FL 33756-3804

Mailing address

203 Amy Cir
North Augusta, SC 29841-2883
Phone (303) 548-2843

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
I20170816003046 FL Practitioner - Emergency Medicine 6709158397 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Area Emergency Physicians LLCGroup PAC ID 2668368952, 9 clinicians

Practice addresses (Care Compare)

300 Pinellas St
Clearwater, FL 33756-3804
Phone (727) 462-7000

Hospital & facility affiliations

  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6817GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pasco County Emergency Physicians LLC Emergency Medicine CurrentSince Jun 1, 2017 Accepting new patients
Bay Area Emergency Physicians LLC Emergency Medicine CurrentSince Jun 1, 2017 Accepting new patients

Locations

300 Pinellas St
#36
Clearwater, FL 33756
Phone (727) 251-4112

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

6600 Madison St
New Pt Richey, FL 34652
Phone (727) 841-4611

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164837688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 AMY CIR",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298412883",
            "telephone_number": "303-548-2843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PINELLAS ST # MS -36",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563804",
            "telephone_number": "727-298-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWANOWSKI",
        "first_name": "MARTIN",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "6817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.