Individual provider Active NPI

Madeline Bach, PA-C

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1306286224
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3100 E Fletcher Ave
Tampa, FL 33613
Phone
(813) 971-6000
NPI assigned
Jun 25, 2013
Last updated
Nov 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9109682 FL
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3100 E Fletcher Ave
Tampa, FL 33613

Mailing address

2620 4TH Ave N
St Petersburg, FL 33713-7808

Other practice location 1

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-2000

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170824000726 FL Practitioner - Physician Assistant 7517192842 Reassigns benefits to 8 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
016732NYMDSpeech-Language Pathologist
9109682FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System/Sunbelt, Inc. Physician Assistant CurrentSince Aug 1, 2021 Accepting new patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince Aug 1, 2021 Accepting new patients
Observation Medical Group LLC CurrentSince Feb 1, 2023 Accepting new patients
Synergic Healthcare Solutions LLC CurrentSince Nov 17, 2018 Accepting new patients
Synergic Healthcare Solutions LLC Current Accepting new patients
Tampa General Hospital Current Accepting new patients
Synergic Healthcare Solutions LLC CurrentSince Nov 17, 2018 Accepting new patients
Urgent Care Centers of Brevard County LLC Physician Assistant CurrentSince Aug 1, 2021 Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

105 S Banana River Blvd
Cocoa Beach, FL 32931
Phone (321) 783-3362

5504 Gateway Blvd
Wesley Chapel, FL 33544
Phone (813) 948-5400

16521 US 301 S
Wimauma, FL 33598
Phone (813) 844-4700

200 N Bryant Ave
Ste 10
Edmond, OK 73034

Interoperability endpoints

  • Direct secure messaging: mbach160901@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1306286224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 4TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337137808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33613",
            "telephone_number": "813-971-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146213001",
            "country_code": "US",
            "telephone_number": "585-922-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACH",
        "first_name": "MADELINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9109682",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.