Organization Active NPI

Surgicalist of FL PLLC

  • Surgery Physician
  • Brooksville, FL
National Provider Identifier
1386795177
Registry record updated Mar 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SURGICALIST OF FL PLLC
Practice address
17222 Hospital Blvd Ste 116
Brooksville, FL 34601-8925
Phone
(813) 866-1959
Fax
(813) 866-1957
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2024

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

Authorized official

Name
Dr. Mit Desai, MDNPI 1407822422
Title
President
Phone
(813) 530-5043

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

17222 Hospital Blvd Ste 116
Brooksville, FL 34601-8925

Mailing address

PO Box 21647
Tampa, FL 33622-1647
Phone (813) 530-5043

Other identifiers 1

IdentifierTypeStateIssuer
280046200MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070802000181 FL Part B Supplier - Clinic/Group Practice 6204927429 Receives reassigned benefits from 3 practitioners
Practice locations: Brooksville, FL

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

18489 N US Highway 41
Unit 2667
Lutz, FL 33548

19105 N US Highway 41
Ste 100
Lutz, FL 33549
Phone (813) 269-2700

11181 Health Park Blvd
#305
Naples, FL 34110
Phone (239) 288-0528

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710547200000",
    "number": "1386795177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21647",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336221647",
            "telephone_number": "813-530-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17222 HOSPITAL BLVD STE 116",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346018925",
            "telephone_number": "813-866-1959",
            "fax_number": "813-866-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICALIST OF FL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2024-03-16",
        "certification_date": "2024-03-16",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "MIT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-530-5043",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280046200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.