Organization Active NPI

Tampa Internist Professional Associate

  • Primary Care Clinic/Center
  • Tampa, FL
National Provider Identifier
1497866560
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
TAMPA INTERNIST PROFESSIONAL ASSOCIATE
Practice address
4543 S Manhattan Ave
Ste. 103
Tampa, FL 33611-2330
Phone
(813) 831-8888
Fax
(813) 831-6292
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Authorized official

Name
Dr. Nimesh Panchigar, MDNPI 1346279148
Title
MD
Phone
(813) 684-5098

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
Primary Care Clinic/Center 261QP2300X FL Primary

Addresses

Primary practice location

4543 S Manhattan Ave
Ste. 103
Tampa, FL 33611-2330

Mailing address

5915 Jaegerglen Dr
Lithia, FL 33547-5864
Phone (813) 684-5098

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070319000248 FL Part B Supplier - Clinic/Group Practice 6901909696 Receives reassigned benefits from 2 practitioners
Practice locations: Tampa, FL

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
10D0291323Tampa Internist PA4543 S Manhattan Ave, Tampa, FL 33611Certificate of waiverJun 16, 2028

National Provider Directory

National Provider Directory

Locations

4543 S Manhattan Ave
Ste 103
Tampa, FL 33611
Phone (813) 831-8888

Practitioners & affiliated clinicians

Practitioners 4

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1497866560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5915 JAEGERGLEN DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335475864",
            "telephone_number": "813-684-5098",
            "fax_number": "813-684-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4543 S MANHATTAN AVE",
            "address_2": "STE. 103",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336112330",
            "telephone_number": "813-831-8888",
            "fax_number": "813-831-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA INTERNIST PROFESSIONAL ASSOCIATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "PANCHIGAR",
        "authorized_official_first_name": "NIMESH",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "813-684-5098",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.