Individual provider Active NPI

Nina Theodora Camperlengo, MD

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1609890128
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME74674 Issued in FL
Practice address
15511 N Florida Ave Ste 401
Tampa, FL 33613-1220
Phone
(813) 963-3124
Fax
(813) 908-7808
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME74674 FL Primary

Addresses

Primary practice location

15511 N Florida Ave Ste 401
Tampa, FL 33613-1220

Mailing address

15511 N Florida Ave Ste 401
Tampa, FL 33613-1220
Phone (813) 963-3124

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
I20211116002879 FL Practitioner - Internal Medicine 7113182387 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

2435 Bexley Village Dr
Suite 200
Land O Lakes, FL 34638-2721
Phone (813) 467-4771

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
  • Adventhealth Wesley Chapel Hospital, Wesley Chapel, FL, CCN 100319
  • Adventhealth North Pinellas Hospital, Tarpon Springs, FL, CCN 100055
  • AdventHealth Carrollwood Hospital, Tampa, FL, CCN 100069

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc Internal Medicine CurrentSince Jan 3, 2022 Accepting new patients
Adventhealth Primary Care Network Inc Internal Medicine CurrentSince Nov 1, 2023 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

2435 Bexley Village Dr
#200
Land O Lakes, FL 34638
Phone (813) 467-4771

2435 Bexley Village Dr
Ste 200
Land O Lakes, FL 34638
Phone (813) 467-4771

15511 N Florida Ave
Ste 108
Tampa, FL 33613
Phone (813) 963-3124

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Interoperability endpoints

  • Direct secure messaging: ncamperlengo227996@adventhealth.direct-ci.com

Organizations & group practices 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1609890128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15511 N FLORIDA AVE STE 401",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131220",
            "telephone_number": "813-963-3124",
            "fax_number": "813-908-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15511 N FLORIDA AVE STE 401",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131220",
            "telephone_number": "813-963-3124",
            "fax_number": "813-908-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPERLENGO",
        "first_name": "NINA",
        "middle_name": "THEODORA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME74674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.