Individual provider Active NPI

Driss Fikry, PHYSICIAN ASSISTANT

  • Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1215326582
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAT9108440 Issued in FL
Practice address
701 6TH St S
St Petersburg, FL 33701-4814
Phone
(727) 893-1234
NPI assigned
Jan 9, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAT9108440 FL Primary

Addresses

Primary practice location

701 6TH St S
St Petersburg, FL 33701-4814

Mailing address

6960 20TH Ave N
Apt 107B
St Petersburg, FL 33710-4798
Phone (727) 455-3478

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160817002131 FL Practitioner - Physician Assistant 0547555419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

603 7TH St S
St Petersburg, FL 33701-4719

701 6TH St S
St Petersburg, FL 33701-4814
Phone (727) 823-1234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PAT9108440FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Ohi West Medical Group, LLC CurrentSince Oct 1, 2020 Accepting new patients

Locations

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

603 7th St S
Ste 500
St Petersburg, FL 33701
Phone (727) 822-0442

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dfikry188727@orlandohealth.medalliesdirect.net

Organizations & group practices 2

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 1

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": "1420761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1215326582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6960 20TH AVE N",
            "address_2": "APT 107B",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337104798",
            "telephone_number": "727-455-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014814",
            "telephone_number": "727-893-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIKRY",
        "first_name": "DRISS",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9108440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.