Individual provider Active NPI

David Faustino Grabau, PSY.D.

  • Clinical Psychologist
  • Tampa, FL
National Provider Identifier
1184705378
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY4386 Issued in FL
Practice address
14802 N Dale Mabry Hwy Ste 304
Tampa, FL 33618-2073
Phone
(813) 728-5449
Fax
(813) 963-0862
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY4386 FL Primary

Addresses

Primary practice location

14802 N Dale Mabry Hwy Ste 304
Tampa, FL 33618-2073

Mailing address

14802 N Dale Mabry Hwy Ste 304
Tampa, FL 33618-2073
Phone (813) 728-5449

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090216000105 FL Practitioner - Clinical Psychologist 2062577661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16066 Dawnview Dr
Tampa, FL 33624-1337
Phone (813) 908-2333

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Performance Group Inc Clinical CurrentSince Nov 1, 2008 Accepting new patients
John P McDonough III PastSince Oct 1, 2004 Accepting new patients

Locations

14802 N Dale Mabry Hwy
Ste 304
Tampa, FL 33618
Phone (813) 728-5449

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1184705378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14802 N DALE MABRY HWY STE 304",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182073",
            "telephone_number": "813-728-5449",
            "fax_number": "813-963-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14802 N DALE MABRY HWY STE 304",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182073",
            "telephone_number": "813-728-5449",
            "fax_number": "813-963-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABAU",
        "first_name": "DAVID",
        "middle_name": "FAUSTINO",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY4386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.