Tampa Bay Renal LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

ME 115872 Issued in FL

Legal business name

TAMPA BAY RENAL LLC

Practice address

508 S Habana Ave
Suite 270
Tampa, FL 33609-4181

Phone

(813) 388-1732

NPI assigned

Nov 3, 2015

Organization subpart

No

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

Authorized official

Name

Chhavi Gupta, MDNPI 1003052945

Title

Manager

Phone

(813) 388-1732

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Kidneyspa Tampa Bay Home LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Tampa, FL
  • NPI 1952091241

  Member Of

  NPD member

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chhavi Gupta, MD

  • Nephrology Physician
  • Tampa, FL
  • NPI 1003052945
  Medicare reassignment NPD Authorized official
• Maricel Gonzalez Figuera

  • Family Nurse Practitioner
  • Tampa, FL
  • NPI 1245195072
  Medicare reassignment
• Bruce Ernst, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Trinity, FL
  • NPI 1548213648
  NPD (past)

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1609249374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 S ROYAL PALM WAY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093718",
            "telephone_number": "813-388-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S HABANA AVE",
            "address_2": "SUITE 270",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094181",
            "telephone_number": "813-388-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA BAY RENAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "CHHAVI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "813-388-1732",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME 115872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.