Individual provider Active NPI

Colin R Chambers, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Lithia, FL
National Provider Identifier
1235481920
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003621 Issued in OH
Practice address
13837 Circa Crossing Dr
Lithia, FL 33547-4382
Phone
(813) 684-2663
Fax
(813) 658-6222
NPI assigned
Oct 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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 50.003621 OH Primary

Addresses

Primary practice location

13837 Circa Crossing Dr
Lithia, FL 33547-4382

Mailing address

13837 Circa Crossing Dr
Lithia, FL 33547-4382
Phone (813) 684-2663

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
I20151209002079 FL Practitioner - Physician Assistant 0446401665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Medical Group of Tampa Bay PAGroup PAC ID 9436220415, 34 clinicians

Practice addresses (Care Compare)

10740 Palm River Rd
Suite 310
Tampa, FL 33619-4577
Phone (813) 684-2663

13837 Circa Crossing Dr
Lithia, FL 33547-4382
Phone (813) 535-6647

2553 Windguard Cir
Wesley Chapel, FL 33544-7351
Phone (813) 684-2663

414 N Plant Ave
Plant City, FL 33563-7248
Phone (813) 684-2663

420 N Plant Ave
Plant City, FL 33563-7248
Phone (813) 684-2663

Hospital & facility affiliations

  • South Florida Baptist Hospital Hospital, Plant City, FL, CCN 100132

National Provider Directory

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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": "1349395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1235481920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13837 CIRCA CROSSING DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474382",
            "telephone_number": "813-684-2663",
            "fax_number": "813-658-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13837 CIRCA CROSSING DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474382",
            "telephone_number": "813-684-2663",
            "fax_number": "813-658-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "COLIN",
        "middle_name": "R",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-05",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithia, FL

Sources for this page

Verify at the official NPI Registry.