Individual provider Active NPI

Kristina Vanessa Maher, PA

  • Medical Physician Assistant
  • Tampa, FL
National Provider Identifier
1366795569
Registry record updated Dec 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PAT9106824 Issued in FL
Practice address
602 S Audubon Ave
Suite B
Tampa, FL 33609-4217
Phone
(813) 348-4885
Fax
(813) 875-4149
NPI assigned
Oct 25, 2012
Last updated
Dec 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PAT9106824 FL Primary

Addresses

Primary practice location

602 S Audubon Ave
Suite B
Tampa, FL 33609-4217

Mailing address

602 S Audubon Ave
Suite B
Tampa, FL 33609-4217
Phone (813) 348-4885

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
I20210414001119 FL Practitioner - Physician Assistant 4587881362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
38.15 of 100Reported as group
Quality
27.91
Improvement activities
0
Cost
74.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAT9106824FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Specialists Group Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kristina.maher.1@31687.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1366795569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 S AUDUBON AVE",
            "address_2": "SUITE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094217",
            "telephone_number": "813-348-4885",
            "fax_number": "813-875-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 S AUDUBON AVE",
            "address_2": "SUITE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094217",
            "telephone_number": "813-348-4885",
            "fax_number": "813-875-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHER",
        "first_name": "KRISTINA",
        "middle_name": "VANESSA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PAT9106824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.