Individual provider Active NPI

Adeline Mae Deladisma, MD

  • Surgery Physician
  • Clearwater, FL
National Provider Identifier
1194845388
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME134033 Issued in FL
Practice address
400 Pinellas St Ste 200
Clearwater, FL 33756-3312
Phone
(727) 462-2131
Fax
(727) 266-4914
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X D72711 MD
Surgery Physician 208600000X 01071770A IN
Surgery Physician 208600000X 00498 GA
Surgery Physician 208600000X ME134033 FL Primary

Addresses

Primary practice location

400 Pinellas St Ste 200
Clearwater, FL 33756-3312

Mailing address

2995 Drew St
Clearwater, FL 33759-3012
Phone (727) 281-9065

Other practice location 1

11141 Parkview Plaza Dr
Suite 305
Fort Wayne, IN 46845-1713
Phone (260) 484-9611

Other identifiers 7

IdentifierTypeStateIssuer
97509402OtherMDBCBS
V8080011OtherDCBCBS
V8380011OtherDCBCBS
V8740011OtherDCBCBS
045199100MedicaidMD
97509401OtherMDBCBS
97509403OtherMDBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Adeline.DeladismaMD@direct.mybaycare.org Direct BayCare Medical Group, Inc.

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
I20200803003347 FL Practitioner - General Surgery 0345410015 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Pennsylvania State University College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

400 Pinellas St
Suite 200
Clearwater, FL 33756-3312
Phone (727) 462-2131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy51
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00498GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Dec 10, 2024 Accepting new patients
University of Florida Jacksonville Physicians Inc Surgery CurrentSince Aug 3, 2020 Accepting new patients
Baycare Medical Group, Inc. Surgery Current Accepting new patients
Baycare Medical Group, Inc CurrentSince Dec 10, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Aug 3, 2020 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Surgery Current Accepting new patients
Associated Surgeons and Physicians, LLC Past Accepting new patients
Indiana Surgical Specialists, LLC Surgery Past Accepting new patients

Locations

2995 Drew St
Clearwater, FL 33759
Phone (727) 315-7496

400 Pinellas St
Ste 200
Clearwater, FL 33756
Phone (727) 462-2131

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

2102 Trinity Oaks Blvd
#202
Trinity, FL 34655
Phone (727) 315-6775

2102 Trinity Oaks Blvd
Ste 205
Trinity, FL 34655
Phone (727) 773-9793

Interoperability endpoints

  • Direct secure messaging: adeline.deladismamd@direct.mybaycare.org

Organizations & group practices 8

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 3

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1194845388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-281-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PINELLAS ST STE 200",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563312",
            "telephone_number": "727-462-2131",
            "fax_number": "727-266-4914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11141 Parkview Plaza Dr",
            "address_2": "Suite 305",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451713",
            "country_code": "US",
            "telephone_number": "260-484-9611",
            "fax_number": "260-484-1004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELADISMA",
        "first_name": "ADELINE",
        "middle_name": "MAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D72711",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01071770A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "00498",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME134033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "97509402",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "V8080011",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "V8380011",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "V8740011",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045199100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "97509401",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "97509403",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Adeline.DeladismaMD@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "400 Pinellas St Ste 200",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337563312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.