Individual provider Active NPI

Annie George Koshy, M.D.

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1376740290
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME102079 Issued in FL
Practice address
711 S Dale Mabry Hwy Ste 201
Tampa, FL 33609-4445
Phone
(813) 548-7860
Fax
(813) 605-6156
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME102079 FL Primary

Addresses

Primary practice location

711 S Dale Mabry Hwy Ste 201
Tampa, FL 33609-4445

Mailing address

711 S Dale Mabry Hwy Ste 201
Tampa, FL 33609-4400
Phone (813) 548-7860

Other identifiers 1

IdentifierTypeStateIssuer
109297800MedicaidFL

Other names 1

  • Dr. Annie George Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address annie.koshymd@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

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
I20091024000025 FL Practitioner - Internal Medicine 4981741923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Wisconsin, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

711 S Dale Mabry Hwy
Tampa, FL 33609-4445

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Nov 25, 2020 Accepting new patients
Baycare Medical Group, Inc. Internal Medicine CurrentSince Nov 25, 2020 Accepting new patients
Baycare Medical Group Pediatric Walk-in Care LLC Past Accepting new patients
Baycare Medical Group Pediatric Walk-in, LLC Past Accepting new patients

Locations

2995 Drew St
Bldg 2ND
Clearwater, FL 33759

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

711 S Dale Mabry Hwy
Ste 201
Tampa, FL 33609
Phone (813) 548-7860

4620 N Habana Ave
Ste 102
Tampa, FL 33614
Phone (727) 723-5060

Interoperability endpoints

  • Direct secure messaging: annie.koshymd@direct.mybaycare.org

Organizations & group practices 4

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 4

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1376740290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 S DALE MABRY HWY STE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094400",
            "telephone_number": "813-548-7860",
            "fax_number": "813-605-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S DALE MABRY HWY STE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094445",
            "telephone_number": "813-548-7860",
            "fax_number": "813-605-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHY",
        "first_name": "ANNIE",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME102079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109297800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "annie.koshymd@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew Street",
            "address_2": "East Bldg 2nd Floor",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "GEORGE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.