Individual provider Active NPI

Ivan Foster Ackerman, M.D

  • Pulmonary Disease Physician
  • Brandon, FL
National Provider Identifier
1609836089
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME48711 Issued in FL
Practice address
402 Noland Dr
Brandon, FL 33511-5709
Phone
(813) 655-9000
Fax
(813) 655-7344
NPI assigned
Mar 28, 2006
Last updated
Dec 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME48711 FL Primary

Addresses

Primary practice location

402 Noland Dr
Brandon, FL 33511-5709

Mailing address

402 Noland Dr
Brandon, FL 33511-5709
Phone (813) 655-9000

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
I20100803001103 FL Practitioner - Pulmonary DiseasePractitioner - Sleep Medicine 4486606845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Sleep Medicine
Education
University Central del Caribe Escuela de Medicina, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa Bay Pulmonary Medicine, PAGroup PAC ID 5991986887, 2 clinicians

Practice addresses (Care Compare)

402 Noland Dr
Brandon, FL 33511-5709
Phone (813) 655-2500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tampabay Pulmonary PA PastSince Sep 1, 2001 Accepting new patients
Bay Area Pulmonary Associates, P.a. Pulmonary Disease Past Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1609836089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 NOLAND DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115709",
            "telephone_number": "813-655-9000",
            "fax_number": "813-655-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 NOLAND DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115709",
            "telephone_number": "813-655-9000",
            "fax_number": "813-655-7344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "IVAN",
        "middle_name": "FOSTER",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME48711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.