Individual provider Active NPI

Olivia Leigh Muratides, PA

  • Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1174092498
Registry record updated Feb 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9111605 Issued in FL
Practice address
1607 Dr Martin Luther King Jr St N
St Petersburg, FL 33704-4203
Phone
(727) 329-8833
NPI assigned
Nov 15, 2018
Reactivated
Jan 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9111605 FL Primary

Addresses

Primary practice location

1607 Dr Martin Luther King Jr St N
St Petersburg, FL 33704-4203

Mailing address

2923 W Knights Ave
Tampa, FL 33611-1621
Phone (813) 817-2466

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
I20190227002306 FL Practitioner - Physician Assistant 7911246400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Center for Neurology, IncGroup PAC ID 6406904978, 3 clinicians

Practice addresses (Care Compare)

1607 Dr Martin Luther King St N
St. Petersburg, FL 33704-4203

1607 Dr Martin Luther King St N
St Petersburg, FL 33704-4226
Phone (727) 329-8834

Hospital & facility affiliations

  • Orlando Health Bayfront Hospital Hospital, Saint Petersburg, FL, CCN 100032
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as group
Quality
94.96
Improvement activities
40
Cost
73.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9111605FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Physician Services, Inc. Past Accepting new patients

Interoperability endpoints

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

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 4

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": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1174092498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2923 W KNIGHTS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336111621",
            "telephone_number": "813-817-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337044203",
            "telephone_number": "727-329-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURATIDES",
        "first_name": "OLIVIA",
        "middle_name": "LEIGH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2019-02-01",
        "deactivation_date": "2018-11-18",
        "reactivation_date": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9111605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.