Individual provider Active NPI

Anthony M Molodecki, PA

  • Medical Physician Assistant
  • Plant City, FL
National Provider Identifier
1417020074
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9101062 Issued in FL
Practice address
228 W Alexander St
Plant City, FL 33563-7157
Phone
(813) 754-5480
Fax
(813) 754-2251
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9101062 FL Primary

Addresses

Primary practice location

228 W Alexander St
Plant City, FL 33563-7157

Mailing address

7200 Corporate Center Dr
#600
Miami, FL 33126-1200
Phone (305) 500-2000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081231000317 FL Practitioner - Physician Assistant 0244392116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Urology Partners LLPGroup PAC ID 2062574924, 66 clinicians

Practice addresses (Care Compare)

12408 N 56TH St
Suite 1
Temple Terrace, FL 33617-1522
Phone (813) 980-3104

5913 Webb Rd
Tampa, FL 33615-3219
Phone (813) 875-8567

6918 Gunn Hwy
Suite B
Tampa, FL 33625-3802
Phone (813) 875-8567

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9101062FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
BPS Tampa, LLC Past Accepting new patients
Florida Urology Partners LLP PastSince Nov 17, 2019 Accepting new patients
Tampa General Provider Network Inc PastSince Jun 1, 2022 Accepting new patients

Locations

2 Columbia Dr
Tampa, FL 33606
Phone (813) 844-7100

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: amolodecki137752@direct.tgh.org

Organizations & group practices 5

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1417020074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 CORPORATE CENTER DR",
            "address_2": "#600",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331261200",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 W ALEXANDER ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335637157",
            "telephone_number": "813-754-5480",
            "fax_number": "813-754-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLODECKI",
        "first_name": "ANTHONY",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

Verify at the official NPI Registry.