Individual provider Active NPI

Phan Qui Lindsey, MD

  • Hospitalist Physician
  • Tampa, FL
National Provider Identifier
1558536698
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME104413 Issued in FL
Practice address
3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone
(813) 554-8093
NPI assigned
Apr 29, 2008
Last updated
Aug 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 001930 GA
Pediatrics Physician 208000000X ME104413 FL
Hospitalist Physician 208M00000X ME104413 FL Primary

Addresses

Primary practice location

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307

Mailing address

PO Box 917770
Orlando, FL 32891-7770
Phone (813) 974-2201

Other identifiers 3

IdentifierTypeStateIssuer
145WEOtherFLBLUE CROSS BLUE SHIELD
001279500MedicaidFL
CI805ZOtherFLMEDICARE PTAN

Other names 1

  • Phan Qui Dang Former name

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
I20090924000235 FL Practitioner - HospitalistPractitioner - Pediatric Medicine 1658427109 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001930GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc CurrentSince Jun 28, 2016 Accepting new patients
University Medical Service Association Inc CurrentSince Jun 28, 2016 Accepting new patients
University Medical Service Association Inc Current Accepting new patients

Locations

12901 N 30th St
Tampa, FL 33612
Phone (813) 974-0703

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

2 Tampa General Cir
Fl 4
University of Tampa, FL 33606
Phone (813) 259-8500

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.

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1558536698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328917770",
            "telephone_number": "813-974-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 W DR MARTIN LUTHER KING JR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076307",
            "telephone_number": "813-554-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSEY",
        "first_name": "PHAN",
        "middle_name": "QUI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-29",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "001930",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME104413",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME104413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "145WE",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001279500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CI805Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHAN",
            "last_name": "DANG",
            "middle_name": "QUI",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.