Individual provider Active NPI

Robert David Bennett, MD

  • Colon & Rectal Surgery Physician
  • Tampa, FL
National Provider Identifier
1376868935
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
ME137739 Issued in FL
Practice address
2 Tampa General Cir
Tampa, FL 33606-3603
Phone
(813) 974-2201
NPI assigned
Apr 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X ME137739 FL Primary

Addresses

Primary practice location

2 Tampa General Cir
Tampa, FL 33606-3603

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other identifiers 2

IdentifierTypeStateIssuer
101057000MedicaidFL
D37HFOtherFLBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rbennett148621@direct.tgh.org

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
I20181105003209 FL Practitioner - Colorectal Surgery (Proctology) 3173876323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
State University of New York at Buffalo School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

13330 Usf Laurel Dr
Tampa, FL 33612-6601

4202 E Fowler Ave
Tampa, FL 33620-6750

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy23
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc CurrentSince Sep 1, 2018 Accepting new patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince Sep 1, 2018 Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

2 Tampa General Cir
Tampa, FL 33606
Phone (813) 259-8700

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rbennett148621@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 5

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 1

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": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1376868935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TAMPA GENERAL CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063603",
            "telephone_number": "813-974-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME137739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101057000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "D37HF",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbennett148621@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.