Organization Active NPI

Mercedes Montealegre MD PA

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1467640987
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME86105 Issued in FL
Legal business name
MERCEDES MONTEALEGRE MD PA
Practice address
12171 W Linebaugh Ave
Tampa, FL 33626-1732
Phone
(813) 855-5455
Fax
(813) 855-9258
NPI assigned
Oct 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Authorized official

Name
Dr. Maria Mercedes Montealegre, M.D.
Title
Doctor
Phone
(813) 855-5455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME86105 FL Primary

Addresses

Primary practice location

12171 W Linebaugh Ave
Tampa, FL 33626-1732

Mailing address

12171 W Linebaugh Ave
Tampa, FL 33626-1732
Phone (813) 855-5455

Other identifiers 5

IdentifierTypeStateIssuer
189854OtherFLAMERIGROUP
10324701OtherFLCITRUS
267380100MedicaidFL
291054OtherFLAVMED
81239OtherFLBLUE CROSS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1018853Mercedes Montealegre MD PA at Westchase12171 W Linebaugh Ave, Tampa, FL 33626Certificate of waiverNov 2, 2027

National Provider Directory

National Provider Directory

Locations

9872 W Linebaugh Ave
Tampa, FL 33626
Phone (813) 920-3500

12171 W Linebaugh Ave
Westchase, FL 33626
Phone (813) 855-5455

Practitioners & affiliated clinicians

Practitioners 1

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": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469059200000",
    "number": "1467640987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12171 W LINEBAUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261732",
            "telephone_number": "813-855-5455",
            "fax_number": "813-855-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12171 W LINEBAUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261732",
            "telephone_number": "813-855-5455",
            "fax_number": "813-855-9258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCEDES MONTEALEGRE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2016-07-21",
        "status": "A",
        "authorized_official_last_name": "MONTEALEGRE",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "MERCEDES",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "813-855-5455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME86105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "189854",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITRUS",
            "identifier": "10324701",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267380100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "291054",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "81239",
            "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 Jul 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.