NPIMap

Organization Active NPI

Tampa General Medical Group Inc

  • Family Medicine Physician
  • Riverview, FL
National Provider Identifier
1235546532
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TAMPA GENERAL MEDICAL GROUP INC
Practice address
11966 Boyette Rd
Riverview, FL 33569-5601
Phone
(813) 672-0408
NPI assigned
Jul 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Authorized official

Name
Dr. Peter T Chang, M.D.
Title
Chief Medical Informatics Officer
Phone
(813) 844-3956

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

11966 Boyette Rd
Riverview, FL 33569-5601

Mailing address

PO Box 1289
Tampa, FL 33601-1289
Phone (813) 844-3956

Other names 1

  • TGMG FCC BOYETTE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160310002525 FL Part B Supplier - Clinic/Group Practice 7416253828 Receives reassigned benefits from 473 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tampa, FL; Sun City Center, FL; Trinity, FL; Valrico, FL; Wesley Chapel, FL; Wimauma, FL; St Petersburg, FL; Apollo Beach, FL…

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

National Provider Directory

National Provider Directory

Locations

11966 Boyette Rd
Riverview, FL 33569
Phone (813) 672-0408

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1235546532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336011289",
            "telephone_number": "813-844-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11966 BOYETTE RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695601",
            "telephone_number": "813-672-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA GENERAL MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CHIEF MEDICAL INFORMATICS OFFICER",
        "authorized_official_telephone_number": "813-844-3956",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TGMG FCC BOYETTE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TGMG FCC BOYETTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.