Individual provider Active NPI

Wilma Alexandra Da Souza, MD

  • Family Medicine Physician
  • Zephyrhills, FL
National Provider Identifier
1497829105
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME113033 Issued in FL
Practice address
37920 Medical Arts CT
Zephyrhills, FL 33541-4323
Phone
(352) 518-2000
Fax
(352) 567-1974
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME113033 FL Primary

Addresses

Primary practice location

37920 Medical Arts CT
Zephyrhills, FL 33541-4323

Mailing address

PO Box 232
Dade City, FL 33526-0232
Phone (352) 518-2000

Other identifiers 1

IdentifierTypeStateIssuer
005953600MedicaidFL

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
I20121009000092 FL Practitioner - Family Practice 5294763249 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME113033FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Community Healthcare Group, Inc. CurrentSince Aug 6, 2012 Accepting new patients
Premier Community Healthcare Group Inc CurrentSince Aug 6, 2012 Accepting new patients
W Alexandra Da Souza MD PC PastSince Jan 1, 1990 Accepting new patients

Locations

14027 5th St
Dade City, FL 33525
Phone (813) 782-6064

37920 Medical Arts Ct
Zephyrhills, FL 33541

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1497829105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335260232",
            "telephone_number": "352-518-2000",
            "fax_number": "352-567-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37920 MEDICAL ARTS CT",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335414323",
            "telephone_number": "352-518-2000",
            "fax_number": "352-567-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DA SOUZA",
        "first_name": "WILMA",
        "middle_name": "ALEXANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME113033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005953600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.