Individual provider Active NPI

Allison M Wyman, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Tampa, FL
National Provider Identifier
1598909889
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
ME115925 Issued in FL
Practice address
2919 W Swann Ave Ste 404
Tampa, FL 33609-4052
Phone
(813) 773-0579
Fax
(941) 253-3401
NPI assigned
Apr 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X ME115925 FL Primary

Addresses

Primary practice location

2919 W Swann Ave Ste 404
Tampa, FL 33609-4052

Mailing address

2410 Northside Dr
Clearwater, FL 33761-2236
Phone (727) 499-0351

Other practice location 1

5460 63rd St E
Bradenton, FL 34203-7808
Phone (813) 773-0579

Other identifiers 2

IdentifierTypeStateIssuer
XBO63OtherFLBLUE CROSS BLUE SHIELD
017766300MedicaidFL

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
I20160809000068 FL Practitioner - Obstetrics/Gynecology 9436443850 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Toledo College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

3225 Aviation Ave
Suite 700
Miami, FL 33133-4741
Phone (305) 273-4641

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME115925FLMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC CurrentSince Apr 1, 2025 Accepting new patients
Florida Surgical Specialists Urogynecology and Reconstructive Pelvic Surgery CurrentSince Nov 1, 2021 Accepting new patients
Allison Wyman MD LLC Urogynecology and Reconstructive Pelvic Surgery CurrentSince Dec 28, 2022 Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

5460 63rd St E
Unit B
Bradenton, FL 34203
Phone (941) 202-2305

5460 63rd St E
Bradenton, FL 34203
Phone (813) 773-0579

607 Manatee Ave E
Ste 102
Bradenton, FL 34208
Phone (941) 216-3602

2410 Northside Dr
Clearwater, FL 33761
Phone (727) 499-0358

6310 Health Park Way
Ste 110A
Lakewood Ranch, FL 34202

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

6600 University Pkwy
Ste 305
Sarasota, FL 34240
Phone (941) 241-0161

2919 W Swann Ave
Ste 404
Tampa, FL 33609
Phone (813) 773-0579

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHDBDA

Organizations & group practices 4

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 5

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": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1598909889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 NORTHSIDE DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612236",
            "telephone_number": "727-499-0351",
            "fax_number": "727-781-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 W SWANN AVE STE 404",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094052",
            "telephone_number": "813-773-0579",
            "fax_number": "941-253-3401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5460 63rd St E",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342037808",
            "country_code": "US",
            "telephone_number": "813-773-0579",
            "fax_number": "941-253-3401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "ALLISON",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-30",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "FL",
            "license": "ME115925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "XBO63",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017766300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.