NPIMap

Organization Active NPI

Mfe Psychiatry LLC

Doing business as Cornerstone Psychiatric Care

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1285256040
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MFE PSYCHIATRY LLC
Doing business as
Cornerstone Psychiatric Care
Practice address
13801 Bruce B Downs Blvd Ste 305
Tampa, FL 33613-3939
Phone
(352) 519-2119
NPI assigned
May 14, 2020
Last updated
Oct 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Marc Ettensohn, MDNPI 1861753899
Title
Ceo Founder
Phone
(352) 519-2119

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

13801 Bruce B Downs Blvd Ste 305
Tampa, FL 33613-3939

Mailing address

13801 Bruce B Downs Blvd Ste 305
Tampa, FL 33613-3939
Phone (352) 519-2119

Other practice location 1

8895 N Military Trl Ste 300E
West Palm Beach, FL 33410-6263
Phone (352) 519-4677

Other names 1

  • Cornerstone Psychiatric Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200622001586 FL Part B Supplier - Clinic/Group Practice 7315369352 Receives reassigned benefits from 11 practitioners
Practice locations: West Palm Beach Garden, FL

National Provider Directory

National Provider Directory

Locations

13801 Bruce B Downs Blvd
Ste 305
Tampa, FL 33613
Phone (352) 519-2119

8895 N Military Trl
Ste 306E
West Palm Beach, FL 33410
Phone (561) 531-7818

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1285256040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13801 BRUCE B DOWNS BLVD STE 305",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133939",
            "telephone_number": "352-519-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 BRUCE B DOWNS BLVD STE 305",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133939",
            "telephone_number": "352-519-2119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8895 N Military Trl Ste 300E",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334106263",
            "country_code": "US",
            "telephone_number": "352-519-4677",
            "fax_number": "844-912-1511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MFE PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "ETTENSOHN",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "CEO FOUNDER",
        "authorized_official_telephone_number": "352-519-2119",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Psychiatric Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 16, 2024; 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.