Individual provider Active NPI

Felicia Hall, M.D.

  • Dermatology Physician
  • Tampa, FL
National Provider Identifier
1316163157
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME97403 Issued in FL
Practice address
3820 Northdale Blvd Ste 200
Tampa, FL 33624-1897
Phone
(813) 712-5702
Fax
(813) 377-1005
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A100908 CA
Dermatology Physician 207N00000X ME97403 FL Primary

Addresses

Primary practice location

3820 Northdale Blvd Ste 200
Tampa, FL 33624-1897

Mailing address

38135 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (352) 567-0188

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dermcw@flmed.directbygreenway.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071017000955 CA Practitioner - Dermatology 5890881171 Reassigns benefits to 1 organization
I20210413001256 FL Practitioner - Dermatology 5890881171 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of South Florida College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Practice addresses (Care Compare)

3820 Northdale Blvd
Suite 200
Tampa, FL 33624-1897
Phone (813) 712-5702

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision69
Removal of skin lesions871
Removal or shaving of skin growth1-10
Skin biopsy253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
100908CAMDMental Health Counselor
A100908CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Square Dermatology a Professional Corporation Dermatology CurrentSince Jan 1, 2009 Accepting new patients
Ohi West Medical Group II LLC CurrentSince Jul 25, 2024 Accepting new patients
Florida Medical Clinic LLC CurrentSince Jan 17, 2023 Accepting new patients
Ohi West Medical Group II LLC CurrentSince Jul 25, 2024 Accepting new patients
Florida Medical Clinic, LLC CurrentSince Jan 17, 2023 Accepting new patients
Ohi West Medical Group II LLC Past Accepting new patients

Locations

450 Sutter St
Rm 830
San Francisco, CA 94108
Phone (415) 362-2238

3820 Northdale Blvd
Ste 200
Tampa, FL 33624
Phone (813) 712-5702

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1316163157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQUARE DR",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188",
            "fax_number": "813-355-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 NORTHDALE BLVD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241897",
            "telephone_number": "813-712-5702",
            "fax_number": "813-377-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "FELICIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A100908",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME97403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dermcw@flmed.directbygreenway.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3820 Northdale Blvd Ste 200",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336241897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.