Individual provider Active NPI

Christopher Narciso Nobo, M.D.

  • Gastroenterology Physician
  • Riverview, FL
National Provider Identifier
1407167919
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME120987 Issued in FL
Practice address
10573 Bloomingdale Ridge Dr
Riverview, FL 33578-5153
Phone
(813) 284-6574
Fax
(813) 284-6803
NPI assigned
Jun 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 166723 NC
Gastroenterology Physician 207RG0100X ME120987 FL Primary

Addresses

Primary practice location

10573 Bloomingdale Ridge Dr
Riverview, FL 33578-5153

Mailing address

505 Columbia Dr Apt 1
Tampa, FL 33606-3937
Phone (352) 514-4778

Other practice location 1

10676 Bloomingdale Ave Ste 1
Riverview, FL 33578-4292
Phone (813) 284-6574

Other identifiers 1

IdentifierTypeStateIssuer
015198500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 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
I20151106001371 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 0547570343 Reassigns benefits to 2 organizations
I20220505001011 GA Practitioner - Gastroenterology 0547570343 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of South Florida College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benchmark Gastro LLCGroup PAC ID 0042657223, 2 clinicians
South Georgia Medical Center IncGroup PAC ID 1052764677, 58 clinicians

Practice addresses (Care Compare)

10676 Bloomingdale Ave
Suite 1
Riverview, FL 33578-4292
Phone (813) 284-6574

2501 N Patterson St
Valdosta, GA 31602-1735
Phone (229) 433-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy92
Upper gastrointestinal (GI) endoscopy for acid reflux68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
166723NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of Valdosta and Lowndes County, Georgia CurrentSince Apr 1, 2022 Accepting new patients
South Georgia Medical Center Inc CurrentSince Nov 1, 2024 Accepting new patients
South Georgia Medical Center Inc CurrentSince Nov 1, 2024 Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia CurrentSince Apr 1, 2022 Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia Current Accepting new patients
Benchmark Gastro, L.L.C. Gastroenterology CurrentSince Mar 1, 2024 Accepting new patients
West Central Gastroenterology LLP Gastroenterology CurrentSince Mar 1, 2022 Accepting new patients

Locations

3001 Executive Dr
Ste 130
Clearwater, FL 33762
Phone (727) 329-3371

6225 66th St N
Pinellas Park, FL 33781
Phone (727) 521-0994

10676 Bloomingdale Ave
Ste 1
Riverview, FL 33578
Phone (813) 284-6574

10573 Bloomingdale Ridge Dr
Riverview, FL 33578
Phone (813) 284-6574

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 7

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 3

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1407167919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 COLUMBIA DR APT 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063937",
            "telephone_number": "352-514-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10573 BLOOMINGDALE RIDGE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335785153",
            "telephone_number": "813-284-6574",
            "fax_number": "813-284-6803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10676 Bloomingdale Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335784292",
            "country_code": "US",
            "telephone_number": "813-284-6574",
            "fax_number": "813-284-6803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOBO",
        "first_name": "CHRISTOPHER",
        "middle_name": "NARCISO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "166723",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME120987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015198500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.