Individual provider Active NPI

Kristi Pejo, MD

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1376123737
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME169283 Issued in FL
Practice address
203 N Marion St
Tampa, FL 33602-4914
Phone
(813) 474-9804
Fax
(813) 540-6025
NPI assigned
Apr 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TX
Internal Medicine Physician 207R00000X ME169283 FL Primary

Addresses

Primary practice location

203 N Marion St
Tampa, FL 33602-4914

Mailing address

203 N Marion St
Tampa, FL 33602-4914
Phone (813) 474-9804

Other practice location 1

3282 College St
Beaumont, TX 77701-4610
Phone (409) 212-7463

Other identifiers 1

IdentifierTypeStateIssuer
124487600MedicaidFL

Other names 1

  • Dr. Kristi Pejo Professional name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241030000074 FL Practitioner - Internal Medicine 9133652142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Specialists GroupGroup PAC ID 0345584835, 66 clinicians

Practice addresses (Care Compare)

203 N Marion St
FL 2
Tampa, FL 33602-4914
Phone (813) 428-6904

Hospital & facility affiliations

  • Orlando Health Bayfront Hospital Hospital, Saint Petersburg, FL, CCN 100032
  • Bayfront Health St. Petersburg Inpatient rehabilitation facility, St. Petersburg, FL, CCN 10T032

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Specialists Group Internal Medicine CurrentSince Dec 1, 2024 Accepting new patients
Inpatient Specialists Group Internal Medicine CurrentSince Dec 1, 2024 Accepting new patients

Locations

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

203 N Marion St
Tampa, FL 33602
Phone (813) 474-9804

203 N Marion St
Fl 2
Tampa, FL 33602
Phone (813) 428-6904

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1618012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1376123737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N MARION ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024914",
            "telephone_number": "813-474-9804",
            "fax_number": "813-540-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N MARION ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024914",
            "telephone_number": "813-474-9804",
            "fax_number": "813-540-6025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3282 College St",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777014610",
            "country_code": "US",
            "telephone_number": "409-212-7463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEJO",
        "first_name": "KRISTI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-10",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME169283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124487600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTI",
            "last_name": "PEJO",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.