NPIMap

Organization Active NPI

Tampa Bay Wound Care Associates MD PLLC

  • Wound Care Registered Nurse
  • St Petersburg, FL
National Provider Identifier
1285401281
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Wound Care Registered NurseTaxonomy code 163WW0000X
Legal business name
TAMPA BAY WOUND CARE ASSOCIATES MD PLLC
Practice address
435 42ND Ave S
St Petersburg, FL 33705-4504
Phone
(251) 901-3011
NPI assigned
Dec 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Authorized official

Name
Pascal Crosley
Title
Office Manager
Phone
(251) 901-3011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X Primary

Addresses

Primary practice location

435 42ND Ave S
St Petersburg, FL 33705-4504

Mailing address

435 42ND Ave S
St Petersburg, FL 33705-4504
Phone (251) 901-3011

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240222002617 FL Part B Supplier - Clinic/Group Practice 2264876762 Receives reassigned benefits from 5 practitioners
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1701993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1285401281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 42ND AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337054504",
            "telephone_number": "251-901-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 42ND AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337054504",
            "telephone_number": "251-901-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA BAY WOUND CARE ASSOCIATES MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-08",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "CROSLEY",
        "authorized_official_first_name": "PASCAL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "251-901-3011"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "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 May 21, 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.