NPIMap

Individual provider Active NPI

Karon R Locicero, MD

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1255307641
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0047336 Issued in FL
Practice address
2605 W Swann Ave
Suite 600
Tampa, FL 33609
Phone
(813) 876-7073
Fax
(813) 879-3737
NPI assigned
Feb 24, 2006
Last updated
Oct 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0047336 FL Primary

Addresses

Primary practice location

2605 W Swann Ave
Suite 600
Tampa, FL 33609

Mailing address

2605 W Swann Ave
Suite 600
Tampa, FL 33609
Phone (813) 876-7073

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
I20090318000494 FL Practitioner - Internal Medicine 3476573155 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Florida College of Medicine, 1984
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Karon R Locicero MD PAGroup PAC ID 3678593357, 18 clinicians
Sports and Orthopedic Rehabilitation Services IncGroup PAC ID 0840104253, shared by 4 NPIs, 314 clinicians

Practice addresses (Care Compare)

2605 W Swann Ave
Suite 600
Tampa, FL 33609-4044
Phone (813) 876-7073

3411 S Dale Mabry Hwy
Suite a Select Physical Therapy
Tampa, FL 33629-8658
Phone (813) 742-9501

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0047336FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Locicero Hospital Group LLC Internal Medicine CurrentSince Jan 6, 2017 Accepting new patients
Karon R Lociero MD Past Accepting new patients

Locations

2605 W Swann Ave
Ste 600
Tampa, FL 33609
Phone (813) 870-2528

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: klocicero8408@direct.tgh.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Canterbury Tower Inc.Tampa, FL, CCN 105326 Skilled nursing facility Adp of the SNF Apr 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1255307641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 W SWANN AVE",
            "address_2": "SUITE 600",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33609",
            "telephone_number": "813-876-7073",
            "fax_number": "813-879-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 W SWANN AVE",
            "address_2": "SUITE 600",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33609",
            "telephone_number": "813-876-7073",
            "fax_number": "813-879-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCICERO",
        "first_name": "KARON",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0047336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.