Individual provider Active NPI

Stamatis Damalos, DO

  • Internal Medicine Physician
  • Palm Harbor, FL
National Provider Identifier
1407485071
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS19358 Issued in FL
Practice address
4705 Alt 19 Ste B
Palm Harbor, FL 34683-1424
Phone
(727) 935-6477
NPI assigned
Apr 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X OS19358 FL Primary

Addresses

Primary practice location

4705 Alt 19 Ste B
Palm Harbor, FL 34683-1424

Mailing address

4705 Alt 19 Ste B
Palm Harbor, FL 34683-1424

Other practice location 1

14000 Fivay Rd
Hudson, FL 34667-7103
Phone (727) 819-2966

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
I20230921003821 FL Practitioner - Internal Medicine 9436503679 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

902 S Pinellas Ave
Tarpon Springs, FL 34689-3714
Phone (727) 935-6477

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Clearwater, FL, CCN 109687
  • Adventhealth Home Health Home health agency, Dade City, FL, CCN 108170
  • Adventhealth North Pinellas Hospital, Tarpon Springs, FL, CCN 100055
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc Internal Medicine CurrentSince Sep 25, 2023 Accepting new patients
Adventhealth Primary Care Network Inc Internal Medicine CurrentSince Nov 1, 2023 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

4140 Woodlands Pkwy
Palm Harbor, FL 34685
Phone (727) 789-1980

4705 Alt 19
Ste B
Palm Harbor, FL 34683
Phone (727) 787-4875

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Organizations & group practices 2

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 6

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1407485071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 ALT 19 STE B",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 ALT 19 STE B",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831424",
            "telephone_number": "727-935-6477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14000 Fivay Rd",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "FL",
            "postal_code": "346677103",
            "country_code": "US",
            "telephone_number": "727-819-2966",
            "fax_number": "727-819-2928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMALOS",
        "first_name": "STAMATIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2023-10-18",
        "certification_date": "2023-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS19358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.