Individual provider Active NPI

Anjum Kumbkarni, MD

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1205825833
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME96569 Issued in FL
Practice address
10004 N Dale Mabry Hwy Ste 101
Tampa, FL 33618-4421
Phone
(813) 931-3999
Fax
(813) 377-1391
NPI assigned
Oct 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME96569 FL Primary

Addresses

Primary practice location

10004 N Dale Mabry Hwy Ste 101
Tampa, FL 33618-4421

Mailing address

38135 Market SQ
Zephyrhills, FL 33542-7505
Phone (352) 567-0188

Other practice location 1

5002 W Lemon St
Tampa, FL 33609
Phone (813) 286-0033

Other identifiers 1

IdentifierTypeStateIssuer
002124300MedicaidFL

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
I20070301000514 FL Practitioner - Internal Medicine 0648295451 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME96569FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Clinic, LLC CurrentSince Jan 27, 2020 Accepting new patients
Womens' Health Hospitalists, LLC CurrentSince Aug 1, 2018 Accepting new patients
Florida Medical Clinic LLC CurrentSince Jan 27, 2020 Accepting new patients
Women's Care Florida LLC CurrentSince Aug 1, 2018 Accepting new patients

Locations

5002 W Lemon St
Tampa, FL 33609

10004 N Dale Mabry Hwy
Ste 101
Tampa, FL 33618
Phone (813) 391-3990

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

Interoperability endpoints

  • Direct secure messaging: anjum.kumbkarni.1@18455.direct.athenahealth.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": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1205825833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 N DALE MABRY HWY STE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336184421",
            "telephone_number": "813-931-3999",
            "fax_number": "813-377-1391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5002 W Lemon St",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "33609",
            "country_code": "US",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUMBKARNI",
        "first_name": "ANJUM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME96569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002124300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.