Individual provider Active NPI

Jacob Wilson Poynter, MD

  • Otolaryngology Physician
  • Tampa, FL
National Provider Identifier
1578129144
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME167517 Issued in FL
Practice address
3000 Medical Park Dr Ste 200
Tampa, FL 33613-4695
Phone
(813) 879-8045
NPI assigned
May 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME167517 FL Primary

Addresses

Primary practice location

3000 Medical Park Dr Ste 200
Tampa, FL 33613-4695

Mailing address

3000 Medical Park Dr Ste 200
Tampa, FL 33613-4695
Phone (813) 879-8045

Other practice location 1

26853 Foggy Creek Rd Ste 101
Wesley Chapel, FL 33544-6777
Phone (813) 879-8045

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
I20240802003901 FL Practitioner - Otolaryngology 6002144037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Michigan State University College of Human Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates of Florida, LLCGroup PAC ID 0042292849, 227 clinicians

Practice addresses (Care Compare)

3000 Medical Park Dr
Suite 200
Tampa, FL 33613-4695
Phone (813) 879-8045

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME167517FLMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates of Florida, LLC Otolaryngology CurrentSince Sep 16, 2024 Accepting new patients

Locations

6421 Congress Ave
Ste 113
Boca Raton, FL 33487
Phone (561) 338-3267

900 NW 13th St
Ste 206
Boca Raton, FL 33486
Phone (561) 338-3267

3000 Medical Park Dr
Ste 200
Tampa, FL 33613
Phone (813) 879-8046

26853 Foggy Creek Rd
Ste 101
Wesley Chapel, FL 33544

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 1

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 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": "1558224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1578129144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL PARK DR STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134695",
            "telephone_number": "813-879-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL PARK DR STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134695",
            "telephone_number": "813-879-8045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26853 Foggy Creek Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335446777",
            "country_code": "US",
            "telephone_number": "813-879-8045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POYNTER",
        "first_name": "JACOB",
        "middle_name": "WILSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-19",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME167517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.