Timothy Maynard, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9108404 Issued in FL

Practice address

3100 E Fletcher Ave
Tampa, FL 33613-4613

Phone

(813) 615-7600

NPI assigned

Jan 12, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Observation Medical Group LLCGroup PAC ID 3779872627, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Observation Medical Group LLC

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1952763682
  Medicare reassignment Care Compare group NPD
• Emergency Medical Associates of Tampa Bay, LLC

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1023397817
  Medicare reassignment
• Pioneer Medical Group, PL

  • Internal Medicine Physician
  • Temple Terrace, FL
  • NPI 1710315775
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1346519816
  Care Compare affiliation
• St. Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1881632818
  Care Compare affiliation

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1215326400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 4TH ST N APT 1005",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337163207",
            "telephone_number": "727-512-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134613",
            "telephone_number": "813-615-7600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2809 S Fern Creek Ave",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328065540",
            "country_code": "US",
            "telephone_number": "407-897-2714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "TIMOTHY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9108404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayi'S Alf Inc
• Mayle Injury Services Inc
• David Mayler III, CRNA
• Alexandra Rae Maynard, LMHC
• Linda Maynard, M.D.
• Kimberly Swann Brown Maynell, APRN
• Johan Michel Mayo Sanchez
• Francisco Alberto Mayo
• John Benjamin Mayo, LMHC
• Monica Michelle Mayo

• Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.