Active NPI
Thomas Alan Nakagawa, MD
- Pediatric Critical Care Medicine Physician
- St Petersburg, FL
National Provider Identifier
1518942473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- ME127112
- Practice address
- 501 6TH Ave S
Dept #6580070302
St Petersburg, FL 33701-4634 - Phone
- (727) 767-4429
- Fax
- (727) 767-8526
- NPI assigned
- Dec 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | ME127112 | FL | Primary |
Addresses
Primary practice location
501 6TH Ave S
Dept #6580070302
St Petersburg, FL 33701-4634
Mailing address
501 6TH Ave S
Dept #6580070302
St Petersburg, FL 33701-4634
Phone (727) 767-4429
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 49015 | Other | PARTNERS | |
| 7356642 | Other | AETNA | |
| 9840886000 | Medicaid | WV | |
| 016874600 | Medicaid | FL | |
| B5785 | Other | MEDCOST | |
| 891307H | Medicaid | NC | |
| 1307H | Other | BCBS | |
| 6736611 | Medicaid | VA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME127112 | FL | MD | Pediatric Critical Care Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Florida Jacksonville Physicians, Inc. | Current | Accepting new patients | |
| University of Florida Jacksonville Physicians, Inc. | Current | Accepting new patients | |
| Childrens Specialty Group PLLC | Past | Accepting new patients |
Locations
1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110
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.
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1144276452
-
dba UF Health Imaging Center-Baymeadows
- Physiological Laboratory
- Jacksonville, FL
- NPI 1831800952
-
- Pediatrics Physician
- Norfolk, VA
- NPI 1255354130
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471392000000",
"number": "1518942473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 6TH AVE S",
"address_2": "DEPT #6580070302",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337014634",
"telephone_number": "727-767-4429",
"fax_number": "727-767-8526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 6TH AVE S",
"address_2": "DEPT #6580070302",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337014634",
"telephone_number": "727-767-4429",
"fax_number": "727-767-8526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAKAGAWA",
"first_name": "THOMAS",
"middle_name": "ALAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-13",
"last_updated": "2016-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "FL",
"license": "ME127112",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "49015",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7356642",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9840886000",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "016874600",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "B5785",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891307H",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1307H",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6736611",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.