Individual provider Active NPI

David Lassiter, PSY.D.

  • Clinical Psychologist
  • Tampa, FL
National Provider Identifier
1245470962
Registry record updated Feb 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY6342 Issued in FL
Practice address
19 Martinique Ave
Tampa, FL 33606-4005
Phone
(813) 431-9306
Fax
(813) 258-6560
NPI assigned
Feb 21, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY6342 FL
Clinical Psychologist 103TC0700X PY6342 FL Primary

Addresses

Primary practice location

19 Martinique Ave
Tampa, FL 33606-4005

Mailing address

19 Martinique Ave
Tampa, FL 33606-4005
Phone (813) 431-9306

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090528000528 FL Practitioner - Clinical Psychologist 9436208170 Practice locations: Plant City, FL; Zephyrhills, FL; Tampa, FL; St Petersburg, FL; Kenneth City, FL

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
John P McDonough III PastSince Oct 1, 2004 Accepting new patients

Networks

  • 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.

NPI Registry JSON

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

{
    "created_epoch": "1235174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235174400000",
    "number": "1245470962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MARTINIQUE AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336064005",
            "telephone_number": "813-431-9306",
            "fax_number": "613-258-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MARTINIQUE AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336064005",
            "telephone_number": "813-431-9306",
            "fax_number": "813-258-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASSITER",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-21",
        "last_updated": "2009-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY6342",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.