NPIMap

Organization Active NPI

Tidewater Total Mind Care, LLC

  • Psychiatry Physician
  • Sarasota, FL
National Provider Identifier
1457097032
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
TIDEWATER TOTAL MIND CARE, LLC
Practice address
2650 Bahia Vista St Ste 204
Sarasota, FL 34239-2625
Phone
(941) 202-1999
Fax
(941) 202-2009
NPI assigned
May 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Dr. Steven Stein, MDNPI 1417319104
Title
Practice Owner
Phone
(813) 299-9439

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2650 Bahia Vista St Ste 204
Sarasota, FL 34239-2625

Mailing address

2650 Bahia Vista St Ste 204
Sarasota, FL 34239-2625
Phone (941) 202-1999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230622000208 FL Part B Supplier - Clinic/Group Practice 0648638734 Receives reassigned benefits from 9 practitioners
Practice locations: Sarasota, FL

National Provider Directory

National Provider Directory

Locations

3333 Clark Rd
Ste 100
Sarasota, FL 34231
Phone (941) 202-1999

2650 Bahia Vista St
Ste 204
Sarasota, FL 34239
Phone (941) 202-1999

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1457097032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 BAHIA VISTA ST STE 204",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392625",
            "telephone_number": "941-202-1999",
            "fax_number": "941-202-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 BAHIA VISTA ST STE 204",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392625",
            "telephone_number": "941-202-1999",
            "fax_number": "941-202-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER TOTAL MIND CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-06",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "813-299-9439",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.