NPIMap

Organization Active NPI

Tampa General Medical Group Inc

Doing business as TGMG Sunlake

  • Family Medicine Physician
  • Lutz, FL
National Provider Identifier
1407698566
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TAMPA GENERAL MEDICAL GROUP INC
Doing business as
TGMG Sunlake
Practice address
19027 Wingshooter Way
Lutz, FL 33558
Phone
(813) 660-7900
Fax
(813) 821-9821
NPI assigned
Jun 10, 2024
Organization subpart
Yes
Parent organization
TAMPA GENERAL MEDICAL GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Authorized official

Name
Peter Travis Riad Chang
Title
SVP Chief Trnsfrmtn Ofcr FHSC
Phone
(813) 844-3956

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

19027 Wingshooter Way
Lutz, FL 33558

Mailing address

PO Box 1289
Tampa, FL 33601-1289
Phone (813) 844-3956

Other names 1

  • TGMG Sunlake Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160310002525 FL Part B Supplier - Clinic/Group Practice 7416253828 Receives reassigned benefits from 473 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tampa, FL; Sun City Center, FL; Trinity, FL; Valrico, FL; Wesley Chapel, FL; Wimauma, FL; St Petersburg, FL; Apollo Beach, FL…

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

National Provider Directory

National Provider Directory
Tax ID family
Tampa General Medical Group47 organizations share this tax ID, including this one
Part of
Tampa General Medical Group

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766102400000",
    "number": "1407698566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336011289",
            "telephone_number": "813-844-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19027 WINGSHOOTER WAY",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "33558",
            "telephone_number": "813-660-7900",
            "fax_number": "813-821-9821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA GENERAL MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TAMPA GENERAL MEDICAL GROUP INC",
        "enumeration_date": "2024-06-10",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "TRAVIS RIAD",
        "authorized_official_title_or_position": "SVP CHIEF TRNSFRMTN OFCR FHSC",
        "authorized_official_telephone_number": "813-844-3956"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TGMG Sunlake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; 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.