Individual provider Active NPI

Michael V. Mazzaferro, MD

  • Emergency Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1558318485
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME56914 Issued in FL
Practice address
6500 38TH Ave N
St Petersburg, FL 33710-1629
Phone
(727) 341-4870
NPI assigned
May 27, 2006
Last updated
Nov 14, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME56914 FL Primary

Addresses

Primary practice location

6500 38TH Ave N
St Petersburg, FL 33710-1629

Mailing address

5407 Bay State Rd
Palmetto, FL 34221
Phone (941) 721-7603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME56914FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inphynet Contracting Services LLC Emergency Medicine Past Accepting new patients
Paragon Contracting Services LLC Emergency Medicine Past Accepting new patients
Venice Emergency Medical Associates PA Emergency Medicine Past Accepting new patients
Sunshine City Emergency Physicians Emergency Medicine Past Accepting new patients
Florida Em-I Medical Services PA Emergency Medicine Past Accepting new patients
Clover Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1558318485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5407 BAY STATE RD",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "34221",
            "telephone_number": "941-721-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 38TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101629",
            "telephone_number": "727-341-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZAFERRO",
        "first_name": "MICHAEL",
        "middle_name": "V.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME56914",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.