Individual provider Active NPI

Rene A Boothby, MD

  • Otolaryngology Physician
  • Tampa, FL
National Provider Identifier
1215023023
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME0044406 Issued in FL
Practice address
Florida ENT & Allergy
5105 N Armenia Ave
Tampa, FL 33603-1405
Phone
(813) 879-8045
Fax
(813) 876-6504
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X ME44406 FL
Otolaryngology Physician 207Y00000X ME0044406 FL Primary

Addresses

Primary practice location

Florida ENT & Allergy
5105 N Armenia Ave
Tampa, FL 33603-1405

Mailing address

Select Physicians Alliance
10002 Princess Palm Ave. Ste 332
Tampa, FL 33619-8327
Phone (813) 571-7184

Other identifiers 1

IdentifierTypeStateIssuer
036277800MedicaidFL

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
I20051026000415 FL Practitioner - Otolaryngology 4082631361

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Puerto Rico School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5105 N Armenia Ave
Tampa, FL 33603-1405

Merit-based Incentive Payment System (MIPS)

Final score
88.95 of 100Reported as individual
Promoting interoperability
87
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0044406FLMDOtolaryngology Physician
ME44406FLMDOtolaryngology/Facial Plastic Surgery Physician

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1215023023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SELECT PHYSICIANS ALLIANCE",
            "address_2": "10002 PRINCESS PALM AVE. STE 332",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336198327",
            "telephone_number": "813-571-7184",
            "fax_number": "813-654-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FLORIDA ENT & ALLERGY",
            "address_2": "5105 N ARMENIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336031405",
            "telephone_number": "813-879-8045",
            "fax_number": "813-876-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTHBY",
        "first_name": "RENE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "FL",
            "license": "ME44406",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME0044406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036277800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.