Individual provider Active NPI

Sydel Legrande, M.D.

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1437289188
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0047234 Issued in FL
Practice address
4816 N Armenia Ave
Ste. a
Tampa, FL 33603-1400
Phone
(813) 443-0866
Fax
(813) 225-1583
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0047234 FL Primary

Addresses

Primary practice location

4816 N Armenia Ave
Ste. a
Tampa, FL 33603-1400

Mailing address

4816 N Armenia Ave
Ste. a
Tampa, FL 33603-1400
Phone (813) 443-0866

Other identifiers 1

IdentifierTypeStateIssuer
042392100MedicaidFL

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
I20051019000571 FL Practitioner - Family Practice 9638195639 Practice locations: Tampa, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0047234FLMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: sydel.legrande@3637.securemail.prognocis.com

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1437289188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4816 N ARMENIA AVE",
            "address_2": "STE. A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336031400",
            "telephone_number": "813-443-0866",
            "fax_number": "813-225-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816 N ARMENIA AVE",
            "address_2": "STE. A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336031400",
            "telephone_number": "813-443-0866",
            "fax_number": "813-225-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGRANDE",
        "first_name": "SYDEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0047234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042392100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.