Bayshore Medical Group P L

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BAYSHORE MEDICAL GROUP P L

Practice address

19947 Tamiami Ave
Tampa, FL 33647-3366

Phone

(813) 716-6959

NPI assigned

Jul 28, 2008

Last updated

Jul 28, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yashitala Agzew, MD

Title

Member

Phone

(813) 716-6959

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yeshitila Agzew, MD

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1801813829
  Medicare reassignment NPD
• Cheryl Steele Newcomb, NP-C

  • Family Nurse Practitioner
  • Tampa, FL
  • NPI 1265821771
  NPD (past)

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1215192372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19947 TAMIAMI AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473366",
            "telephone_number": "813-716-6959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19947 TAMIAMI AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473366",
            "telephone_number": "813-716-6959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSHORE MEDICAL GROUP P L",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-28",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "AGZEW",
        "authorized_official_first_name": "YASHITALA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "813-716-6959",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suthida Bayrasy
• Kiara Michelle Bayron
• Darlene Edillor Baysa, ARNP
• Bayshore Geriatric Solutions, Inc.
• Bayshore Home Health Care, Inc.
• Bayshore Nutrition LLC
• Bayshore Orthodontics PLLC
• Bayshore Pediatric Dentistry and Orthodontics PLLC
• Bayshore Podiatry Center
• Bayshore Podiatry Center Inc (Bayshore Podiatry Center)

• Internal Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.