Individual provider Active NPI

Nishit Jailwala, M.D.

  • Internal Medicine Physician
  • Temple Terrace, FL
National Provider Identifier
1508251315
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME136058 Issued in FL
Practice address
13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926
Phone
(813) 779-6303
Fax
(888) 977-1998
NPI assigned
Mar 30, 2015
Last updated
Jun 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X WV-SE-1793 WV
Internal Medicine Physician 207R00000X ME136058 FL Primary
Hospitalist Physician 208M00000X ME136058 FL
Hospitalist Physician 208M00000X WV-SE-1793 WV

Addresses

Primary practice location

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926

Mailing address

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926
Phone (813) 779-6303

Other practice location 1

1200 J D Anderson Dr
Morgantown, WV 26505-3494
Phone (304) 598-1200

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
I20180726002376 FL Practitioner - HospitalistPractitioner - Internal Medicine 9739436437 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pioneer Medical Group PLGroup PAC ID 8224266655, 68 clinicians
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926
Phone (813) 779-6303

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260

2600 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9207
Phone (813) 929-5436

2700 Healing Way
Wesley Chapel, FL 33543-5453

3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (813) 615-7075

7050 Gall Blvd
Zephyrhills, FL 33541-1347
Phone (813) 788-0411

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
Pioneer Medical Group, PL Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients

Locations

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

12470 Telecom Dr
Ste 100
Temple Terrace, FL 33637
Phone (813) 929-5454

13067 N Telecom Pkwy
Temple Terrace, FL 33637
Phone (813) 333-9108

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

38250 A Ave
Zephyrhills, FL 33542
Phone (813) 732-5608

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Adventhealth ZephyrhillsZephyrhills, FL, CCN 100046 Hospital Corporate Director Jan 1, 2025
Adventhealth Dade CityDade City, FL, CCN 100211 Hospital Corporate Director Jan 1, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1508251315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13067 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370926",
            "telephone_number": "813-779-6303",
            "fax_number": "888-977-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13067 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370926",
            "telephone_number": "813-779-6303",
            "fax_number": "888-977-1998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 J D Anderson Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265053494",
            "country_code": "US",
            "telephone_number": "304-598-1200",
            "fax_number": "304-598-1699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAILWALA",
        "first_name": "NISHIT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-30",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "WV-SE-1793",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME136058",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME136058",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WV",
            "license": "WV-SE-1793",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.