Individual provider Active NPI

Etta Lisa Lowery, D.O.

  • Anesthesiology Physician
  • Tampa, FL
National Provider Identifier
1508802430
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OS0004681 Issued in FL
Practice address
1 Tampa General Cir
Suite A327
Tampa, FL 33606-3571
Phone
(813) 844-4396
Fax
(813) 844-4972
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X OS0004681 FL Primary

Addresses

Primary practice location

1 Tampa General Cir
Suite A327
Tampa, FL 33606-3571

Mailing address

1 Tampa General Cir
Suite A327
Tampa, FL 33606-3571
Phone (813) 844-4396

Other identifiers 2

IdentifierTypeStateIssuer
043803100MedicaidFL
80158OtherFLBCBS

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
I20100312000010 FL Practitioner - Anesthesiology 8022143379 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
West Virginia School of Osteopathic Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunshine State Anesthesia Partners LLCGroup PAC ID 8123434792, 429 clinicians

Practice addresses (Care Compare)

1501 Pasadena Ave S
South Pasadena, FL 33707-3717
Phone (727) 381-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS0004681FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC Anesthesiology CurrentSince Jan 1, 2010 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Jan 1, 2010 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Anesthesiology Current Accepting new patients
Sunshine State Anesthesia Partners LLC Anesthesiology CurrentSince Feb 28, 2021 Accepting new patients

Locations

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

2025 Indian Rocks Rd S
Largo, FL 33774
Phone (727) 581-9474

1501 Pasadena Ave S
South Pasadena, FL 33707
Phone (727) 341-7777

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

1 Tampa General Cir
Ste A327
Tampa, FL 33606
Phone (813) 635-5817

400 N Ashley Dr
Ste 1625
Tampa, FL 33602
Phone (813) 289-6597

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Networks

  • Optimum HealthCare HMO Network

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 1

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1508802430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TAMPA GENERAL CIR",
            "address_2": "SUITE A327",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "813-844-4396",
            "fax_number": "813-844-4972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TAMPA GENERAL CIR",
            "address_2": "SUITE A327",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "813-844-4396",
            "fax_number": "813-844-4972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWERY",
        "first_name": "ETTA",
        "middle_name": "LISA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "OS0004681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043803100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "80158",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.