Organization Active NPI

David a Levine M D Inc

  • Geriatric Medicine (Family Medicine) Physician
  • St Petersburg, FL
National Provider Identifier
1275853590
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
ME51828 Issued in FL
Legal business name
DAVID A LEVINE M D INC
Practice address
4957 38TH Ave N
Suite B
St Petersburg, FL 33710-2174
Phone
(727) 522-8878
Fax
(727) 521-1192
NPI assigned
Jun 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Authorized official

Name
David A Levine, M.D.NPI 1114914249
Title
Owner/President
Phone
(727) 522-8878

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X ME51828 FL Primary

Addresses

Primary practice location

4957 38TH Ave N
Suite B
St Petersburg, FL 33710-2174

Mailing address

4957 38TH Ave N
Suite B
St Petersburg, FL 33710-2174
Phone (727) 522-8878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100712000241 FL Part B Supplier - Clinic/Group Practice 0941332928 Receives reassigned benefits from 1 practitioner
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

4957 38th Ave N
Ste B
St Petersburg, FL 33710
Phone (727) 522-8878

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1275853590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4957 38TH AVE N",
            "address_2": "SUITE B",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337102174",
            "telephone_number": "727-522-8878",
            "fax_number": "727-521-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4957 38TH AVE N",
            "address_2": "SUITE B",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337102174",
            "telephone_number": "727-522-8878",
            "fax_number": "727-521-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A LEVINE M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-09",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "727-522-8878",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME51828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.