Individual provider Active NPI

David L Joseph, M.D.

  • Nephrology Physician
  • Tampa, FL
National Provider Identifier
1366424129
Registry record updated Jan 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME85229 Issued in FL
Practice address
3500 E Fletcher Ave
Suite 218
Tampa, FL 33613-4708
Phone
(813) 910-8708
Fax
(813) 910-7386
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 15443R LA
Nephrology Physician 207RN0300X ME85229 FL Primary

Addresses

Primary practice location

3500 E Fletcher Ave
Suite 218
Tampa, FL 33613-4708

Mailing address

3500 E Fletcher Ave
Suite 218
Tampa, FL 33613-4708
Phone (813) 910-8708

Other identifiers 1

IdentifierTypeStateIssuer
1D277336800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20151231000952 TN Order and Referring Only - NephrologyPractitioner - Nephrology 6800868175

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15443RLAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael G Russo MD a Professionsl LLC Past Accepting new patients
Westbank Nephrology, Apmc Nephrology Past Accepting new patients

Organizations & group practices 2

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388966400000",
    "number": "1366424129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 E FLETCHER AVE",
            "address_2": "SUITE 218",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134708",
            "telephone_number": "813-910-8708",
            "fax_number": "813-910-7386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 E FLETCHER AVE",
            "address_2": "SUITE 218",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134708",
            "telephone_number": "813-910-8708",
            "fax_number": "813-910-7386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2014-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "15443R",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME85229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1D277336800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.