Active NPI
Mara Faith Keys, PA-C
- Physician Assistant
- Tampa, FL
National Provider Identifier
1275597833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA3540
- Practice address
- 1300 Bruce B Downs Blvd
Tampa, FL 33612-9217 - Phone
- (813) 972-2000
- Fax
- (813) 903-4874
- NPI assigned
- Apr 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA3540 | FL | Primary |
Addresses
Primary practice location
1300 Bruce B Downs Blvd
Tampa, FL 33612-9217
Mailing address
9317 Heritage Oak CT
Tampa, FL 33647-2536
Phone (813) 991-7988
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: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200723001629 | FL | Order and Referring Only - Physician Assistant | 5395169395 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA3540 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231372800000",
"number": "1275597833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9317 HERITAGE OAK CT",
"city": "TAMPA",
"state": "FL",
"postal_code": "336472536",
"telephone_number": "813-991-7988",
"fax_number": "866-299-3968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 BRUCE B DOWNS BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336129217",
"telephone_number": "813-972-2000",
"fax_number": "813-903-4874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEYS",
"first_name": "MARA",
"middle_name": "FAITH",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-12",
"last_updated": "2009-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA3540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.