NPIMap

Individual provider Active NPI

Mitchell Thomas Fehlberg, MD

  • Diagnostic Radiology Physician
  • Clearwater, FL
National Provider Identifier
1245694991
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME153706 Issued in FL
Practice address
1106 Druid Rd S Ste 302
Clearwater, FL 33756-3841
Phone
(727) 441-3711
NPI assigned
Apr 8, 2016
Last updated
Jul 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME153706 FL Primary

Addresses

Primary practice location

1106 Druid Rd S Ste 302
Clearwater, FL 33756-3841

Mailing address

PO Box 917368
Orlando, FL 32891-0001
Phone (727) 793-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211228002002 FL Practitioner - Diagnostic Radiology 4082901566 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Florida College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Diagnostic Center LLCGroup PAC ID 3779484928, 89 clinicians
Morton Plant Health Services IncGroup PAC ID 2163336777, 88 clinicians
Radiology Associates of ClearwaterGroup PAC ID 5496732067, 54 clinicians

Practice addresses (Care Compare)

12780 Race Track Rd
Suite 100
Tampa, FL 33626-1395
Phone (813) 749-7810

2102 Trinity Oaks Blvd
Trinity, FL 34655-4409
Phone (727) 372-4000

300 Pinellas St
Clearwater, FL 33756-3804
Phone (727) 462-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME153706FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morton Plant Mease Health Services Inc Diagnostic Radiology CurrentSince Feb 14, 2022 Accepting new patients
Baycare Outpatient Imaging LLC Diagnostic Radiology CurrentSince Feb 2, 2026 Accepting new patients
Morton Plant Mease Health Services Inc Diagnostic Radiology CurrentSince Feb 14, 2022 Accepting new patients
St Josephs Diagnostic Center LLC Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Baycare Outpatient Imaging LLC Diagnostic Radiology CurrentSince Feb 2, 2026 Accepting new patients
St Joseph's Diagnostic Center LLC Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Premier Radiology, LLP Diagnostic Radiology PastSince Jan 2, 2022 Accepting new patients

Locations

323 Jeffords St
Clearwater, FL 33756
Phone (727) 462-7560

400 Pinellas St
Ste 101
Clearwater, FL 33756
Phone (727) 462-7514

18600 Fernview St
Ste 101
Land O Lakes, FL 34638
Phone (813) 692-8010

3890 Tampa Rd
#H
Palm Harbor, FL 34684
Phone (813) 781-3164

8787 Bryan Dairy Rd
Seminole, FL 33777
Phone (727) 391-4758

12780 Race Track Rd
Ste 100
Tampa, FL 33626
Phone (813) 749-7810

3003 W Mlk Blvd
Tampa, FL 33607
Phone (813) 357-0630

2102 Trinity Oaks Blvd
Trinity, FL 34655
Phone (727) 372-4000

2470 Bloomingdale Ave
Ste 115
Valrico, FL 33596
Phone (727) 281-9390

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mfehlberg406558@direct.hopkinsmedicine.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1245694991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917368",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "727-793-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 DRUID RD S STE 302",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563841",
            "telephone_number": "727-441-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEHLBERG",
        "first_name": "MITCHELL",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-08",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME153706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.