NPIMap

Organization Active NPI

Oakstead Primary Care, Inc.

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1447201736
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME90171 Issued in FL
Legal business name
OAKSTEAD PRIMARY CARE, INC.
Practice address
12855 Darby Ridge Dr
Tampa, FL 33624-4304
Phone
(813) 968-9695
Fax
(813) 264-0342
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

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

Authorized official

Name
Manjari Ilesh Patel, M.D.
Title
President
Phone
(813) 968-9695

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME90171 FL Primary

Addresses

Primary practice location

12855 Darby Ridge Dr
Tampa, FL 33624-4304

Mailing address

12855 Darby Ridge Dr
Tampa, FL 33624-4304
Phone (813) 968-9695

Other identifiers 1

IdentifierTypeStateIssuer
274304300MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232409600000",
    "number": "1447201736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12855 DARBY RIDGE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336244304",
            "telephone_number": "813-968-9695",
            "fax_number": "813-264-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12855 DARBY RIDGE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336244304",
            "telephone_number": "813-968-9695",
            "fax_number": "813-264-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKSTEAD PRIMARY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2009-01-20",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MANJARI",
        "authorized_official_middle_name": "ILESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-968-9695",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME90171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274304300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.