Individual provider Active NPI

Mark Andrew Bilella, MD

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1447200803
Registry record updated Dec 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME87304 Issued in FL
Practice address
10111 Wilsky Blvd
Tampa, FL 33625
Phone
(813) 961-2222
Fax
(813) 961-2220
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2010

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 ME87304 FL Primary
Pediatrics Physician 208000000X ME87304 FL

Addresses

Primary practice location

10111 Wilsky Blvd
Tampa, FL 33625

Mailing address

10111 Wilsky Blvd
Tampa, FL 33625
Phone (813) 961-2222

Other identifiers 13

IdentifierTypeStateIssuer
2107756OtherFLFIRST HEALTH
916502OtherFLUSA
1000150OtherFLCITRUS HEALTHCARE
1891OtherFLBAYCARE
360122OtherFLAETNA-ADULT
456279OtherFLAETNA-PEDIATRICS
81240OtherFLBLUE CROSS/BLUE SHIELD
188455OtherFLAMERIGROUP
06599OtherFLUNIVERSAL HEALTH CARE
267054200MedicaidFL
7158408OtherFLCIGNA
224474OtherFLWELLCARE
290716OtherFLAVMED

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
I20070328000511 FL Practitioner - Internal Medicine 5092819227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine and Pediatrics of Tampa Bay PAGroup PAC ID 1951309970, 4 clinicians

Practice addresses (Care Compare)

10111 Wilsky Blvd
Tampa, FL 33625-5837
Phone (813) 961-2222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME87304FLMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine & Pediatrics of Tampa Bay PA Internal Medicine CurrentSince Sep 1, 2003 Accepting new patients

Locations

10111 Wilsky Blvd
Tampa, FL 33625
Phone (813) 792-1113

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1447200803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10111 WILSKY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33625",
            "telephone_number": "813-961-2222",
            "fax_number": "813-961-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10111 WILSKY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33625",
            "telephone_number": "813-961-2222",
            "fax_number": "813-961-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILELLA",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME87304",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME87304",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2107756",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA",
            "identifier": "916502",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITRUS HEALTHCARE",
            "identifier": "1000150",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BAYCARE",
            "identifier": "1891",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA-ADULT",
            "identifier": "360122",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA-PEDIATRICS",
            "identifier": "456279",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "81240",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "188455",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSAL HEALTH CARE",
            "identifier": "06599",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267054200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7158408",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "224474",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "290716",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.