Individual provider Active NPI

Danielle N Fasciano, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • St Petersburg, FL
National Provider Identifier
1376997668
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
OS18947 Issued in FL
Practice address
1200 7TH Ave N
St Petersburg, FL 33705-1300
Phone
(205) 934-4060
NPI assigned
Apr 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X OS18947 FL Primary

Addresses

Primary practice location

1200 7TH Ave N
St Petersburg, FL 33705-1300

Mailing address

6671 13TH Ave N Ste 1B
St Petersburg, FL 33710-5411
Phone (727) 328-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230517000418 FL Practitioner - Pathology 7719265206 Reassigns benefits to 3 organizations
I20230731002398 CA Practitioner - Dermatology 7719265206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of South Florida College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Associates PAGroup PAC ID 7719044270, 6 clinicians
Associated Pathologists, PAGroup PAC ID 8123176245, 21 clinicians
Surgical Pathology Laboratories PAGroup PAC ID 4385785880, 9 clinicians

Practice addresses (Care Compare)

1200 7TH Ave N
St Petersburg, FL 33705-1300
Phone (727) 328-7800

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone (813) 870-4205

8455 66TH St N
Pinellas Park, FL 33781-1206
Phone (727) 545-0109

Hospital & facility affiliations

  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21112CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates PA Anatomic Pathology & Clinical Pathology CurrentSince Apr 3, 2023 Accepting new patients

Locations

6671 13th Ave N
Ste 1B
St Petersburg, FL 33710
Phone (727) 328-7800

1200 7th Ave N
St Petersburg, FL 33705
Phone (727) 820-7764

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 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": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376997668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6671 13TH AVE N STE 1B",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105411",
            "telephone_number": "727-328-7800",
            "fax_number": "727-328-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 7TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051300",
            "telephone_number": "205-934-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASCIANO",
        "first_name": "DANIELLE",
        "middle_name": "N",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "OS18947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.