Individual provider Active NPI

Paul M Cavallaro, MD

  • Surgery Physician
  • Tampa, FL
National Provider Identifier
1255710166
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME163115 Issued in FL
Practice address
2 Tampa General Cir
Tampa, FL 33606-3571
Phone
(813) 821-8038
NPI assigned
May 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X L-262966 MA
Surgery Physician 208600000X ME163115 FL Primary

Addresses

Primary practice location

2 Tampa General Cir
Tampa, FL 33606-3571

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other practice location 1

Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114
Phone (617) 726-2800

Other identifiers 2

IdentifierTypeStateIssuer
118966600MedicaidFL
GRFZGOtherFLBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pcavallaro270487@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180827001856 MA Practitioner - General Surgery 2769797562 Reassigns benefits to 2 organizations
I20230805000149 FL Practitioner - General Surgery 2769797562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

13330 Usf Laurel Dr
Tampa, FL 33612-6601

4202 E Fowler Ave
Tampa, FL 33620-6750

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy21
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME163115FLMDSurgery Physician
L-262966MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc Surgery CurrentSince Jul 26, 2023 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
Tampa General Hospital Current Accepting new patients
Lahey Clinic, Inc. CurrentSince Sep 10, 2018 Accepting new patients
University Medical Service Association Inc CurrentSince Jul 26, 2023 Accepting new patients
Lahey Clinic, Inc CurrentSince Sep 10, 2018 Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

2 Tampa General Cir
Tampa, FL 33606
Phone (813) 259-8700

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

55 Fruit St
#S501002
Boston, MA 02114

55 Fruit St
Boston, MA 02114

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 7

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": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1255710166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TAMPA GENERAL CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "813-821-8038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Massachusetts General Hospital",
            "address_2": "55 Fruit St.",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02114",
            "country_code": "US",
            "telephone_number": "617-726-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAVALLARO",
        "first_name": "PAUL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "L-262966",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME163115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118966600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "GRFZG",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcavallaro270487@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.