Individual provider Active NPI

Michael James Iliff, ARNP

  • Adult Health Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1447617527
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN9269955 Issued in FL
Practice address
603 7TH St S
St Petersburg, FL 33701-4719
Phone
(727) 893-6254
Fax
(727) 553-7158
NPI assigned
Jan 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9269955 FL
Adult Health Nurse Practitioner 363LA2200X APRN9269955 FL Primary

Addresses

Primary practice location

603 7TH St S
St Petersburg, FL 33701-4719

Mailing address

603 7TH St S
St Petersburg, FL 33701-4719
Phone (727) 893-6254

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
I20160603000391 FL Practitioner - Nurse Practitioner 9830489830 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

603 7TH St S
St Petersburg, FL 33701-4719
Phone (727) 893-6254

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9269955FLMDAdult Health Nurse Practitioner
ARNP9269955FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohi West Medical Group, LLC CurrentSince Dec 16, 2021 Accepting new patients
Ohi West Medical Group, LLC CurrentSince Dec 16, 2021 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
FL-I Medical Services, LLC Current Accepting new patients
FL-I Medical Services LLC CurrentSince Feb 8, 2018 Accepting new patients
FL-I Medical Services LLC CurrentSince Feb 8, 2018 Accepting new patients

Locations

2020 59th St W
Bradenton, FL 34209
Phone (813) 798-6303

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

1414 Kuhl Ave
#38
Orlando, FL 32806
Phone (407) 481-7179

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

603 7th St S
St Petersburg, FL 33701
Phone (727) 553-7750

603 7th St S
Ste 500
St Petersburg, FL 33701
Phone (727) 822-0442

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: miliff314152@orlandohealth.medalliesdirect.net

Organizations & group practices 6

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 1

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": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1447617527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 7TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014719",
            "telephone_number": "727-893-6254",
            "fax_number": "727-553-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 7TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014719",
            "telephone_number": "727-893-6254",
            "fax_number": "727-553-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILIFF",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-20",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9269955",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9269955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.