Individual provider Active NPI

Tetyana Metyk, MD

  • Internal Medicine Physician
  • Port Charlotte, FL
National Provider Identifier
1528354255
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 118619 Issued in FL
Practice address
3191 Harbor Blvd
Port Charlotte, FL 33952-6755
Phone
(941) 613-1919
NPI assigned
Jun 21, 2011
Last updated
Aug 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 118619 FL Primary

Addresses

Primary practice location

3191 Harbor Blvd
Port Charlotte, FL 33952-6755

Mailing address

3191 Harbor Blvd
Port Charlotte, FL 33952-6755
Phone (941) 613-1919

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
I20140617001841 FL Practitioner - Internal Medicine 2163667122 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2811 Tamiami TRL
Suite I
Port Charlotte, FL 33952-5135
Phone (941) 613-1919

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 118619FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Harbor Wellness P a Internal Medicine CurrentSince Jun 28, 2023 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Jan 9, 2016 Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Jan 9, 2016 Accepting new patients

Locations

2811 Tamiami Trl
Ste I
Pt Charlotte, FL 33952
Phone (941) 246-2700

3191 Harbor Blvd
Ste D
Pt Charlotte, FL 33952
Phone (941) 334-6634

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1528354255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3191 HARBOR BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526755",
            "telephone_number": "941-613-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 HARBOR BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526755",
            "telephone_number": "941-613-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METYK",
        "first_name": "TETYANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 118619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.