Individual provider Active NPI

Saleem R. Khamisani, M.D.

  • Neurology Physician
  • Saint Petersburg, FL
National Provider Identifier
1497762041
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME83502 Issued in FL
Practice address
1201 5TH Avenue
Ste 202
Saint Petersburg, FL 33705-1410
Phone
(727) 820-7701
Fax
(727) 820-7700
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME83502 FL Primary

Addresses

Primary practice location

1201 5TH Avenue
Ste 202
Saint Petersburg, FL 33705-1410

Mailing address

1201 5TH Ave N Ste 202
St Petersburg, FL 33705-1410
Phone (727) 820-7701

Other identifiers 2

IdentifierTypeStateIssuer
P00759244OtherFLRAILROAD MEDICARE PROVIDER NUMBER
273445100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address saleem.khamisani@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

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
I20040428000447 FL Practitioner - Neurology 0244227650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

1200 7TH Ave N
St Petersburg, FL 33705-1300
Phone (727) 820-7737

1201 5TH Ave N
Suite 202
St Petersburg, FL 33705-1410
Phone (727) 820-7701

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

Hospital & facility affiliations

  • Baycare Home Care Inc Home health agency, Largo, FL, CCN 107212
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • St Anthonys Hospital Hospital, Saint Petersburg, FL, CCN 100067
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127
  • Mease Countryside Hospital Hospital, Safety Harbor, FL, CCN 100265

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME83502FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Sep 1, 2015 Accepting new patients
Baycare Medical Group, Inc. Neurology CurrentSince Sep 1, 2015 Accepting new patients
St. Anthony'S Specialists LLC Past Accepting new patients
Saint Petersburg Neurology Clinic Neurology Past Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2995 Drew St
Bldg 2ND
Clearwater, FL 33759

1201 5th Ave N
Ste 202
St Petersburg, FL 33705
Phone (727) 820-7701

900 Carillon Pkwy
Ste 303
St Petersburg, FL 33716
Phone (727) 556-0363

Interoperability endpoints

  • Direct secure messaging: saleem.khamisani@direct.mybaycare.org

Organizations & group practices 4

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 6

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1497762041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE N STE 202",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051410",
            "telephone_number": "727-820-7701",
            "fax_number": "727-820-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 5TH AVENUE",
            "address_2": "STE 202",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337051410",
            "telephone_number": "727-820-7701",
            "fax_number": "727-820-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMISANI",
        "first_name": "SALEEM",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME83502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDER NUMBER",
            "identifier": "P00759244",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273445100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "saleem.khamisani@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew Street",
            "address_2": "East Bldg 2nd Floor",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

Verify at the official NPI Registry.