Organization Active NPI

Total Vitality Medical Group, LLC

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1376583609
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TOTAL VITALITY MEDICAL GROUP, LLC
Practice address
24945 US Highway 19 N
Clearwater, FL 33763-3927
Phone
(727) 726-1460
Fax
(727) 724-9705
NPI assigned
Jun 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Authorized official

Name
Adam S Rosoff, DCNPI 1700111697
Title
Owner
Phone
(727) 726-1460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

24945 US Highway 19 N
Clearwater, FL 33763-3927

Mailing address

24945 US Highway 19 N
Clearwater, FL 33763-3927
Phone (727) 726-1460

Other practice location 1

1001 37th St N Ste D
St Petersburg, FL 33713-6010
Phone (727) 914-9130

Other practice location 2

667 W Lumsden Rd
Brandon, FL 33511-5911
Phone (813) 867-7323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041108000230 FL Part B Supplier - Clinic/Group Practice 6103887195 Receives reassigned benefits from 9 practitioners
Practice locations: Clearwater, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2090171Total Vitality Medical Group LLC1001 37TH St N Ste D, Saint Petersburg, FL 33713Certificate of waiverJan 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Team Mua4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

667 W Lumsden Rd
Brandon, FL 33511
Phone (813) 867-7323

26750 US Highway 19 N
Ste 100
Clearwater, FL 33761
Phone (727) 726-1460

1001 37th St N
St Petersburg, FL 33713
Phone (727) 384-3338

1001 37th St N
Ste D
St Petersburg, FL 33713
Phone (727) 327-6897

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1376583609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24945 US HIGHWAY 19 N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337633927",
            "telephone_number": "727-726-1460",
            "fax_number": "727-724-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24945 US HIGHWAY 19 N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337633927",
            "telephone_number": "727-726-1460",
            "fax_number": "727-724-9705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 37th St N Ste D",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337136010",
            "country_code": "US",
            "telephone_number": "727-914-9130",
            "fax_number": "727-914-9131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "667 W Lumsden Rd",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115911",
            "country_code": "US",
            "telephone_number": "813-867-7323",
            "fax_number": "813-867-7326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TOTAL VITALITY MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A",
        "authorized_official_last_name": "ROSOFF",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-726-1460",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.