Individual provider Active NPI

Clinton Gabriel Keilman, M.D.

  • Emergency Medicine Physician
  • Tampa, FL
National Provider Identifier
1619031267
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME128366 Issued in FL
Practice address
2502 W Saint Isabel St
Tampa, FL 33607-6318
Phone
(813) 874-5707
Fax
(813) 874-5908
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 010240374 VA
Emergency Medicine Physician 207P00000X ME128366 FL Primary

Addresses

Primary practice location

2502 W Saint Isabel St
Tampa, FL 33607-6318

Mailing address

2502 W Saint Isabel St
Tampa, FL 33607-6318
Phone (813) 874-5707

Other practice location 1

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (813) 745-0612

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
I20161101002766 FL Practitioner - Emergency Medicine 9739268079 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME128366FLMDEmergency Medicine Physician
010240374VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inphynet Contracting Services LLC Emergency Medicine CurrentSince May 1, 2018 Accepting new patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc CurrentSince Mar 19, 2019 Accepting new patients
Observation Medical Group LLC Emergency Medicine CurrentSince Jun 2, 2018 Accepting new patients
Emergency Medical Associates of Tampa Bay, LLC Emergency Medicine CurrentSince Jun 2, 2018 Accepting new patients
Observation Medical Group LLC Emergency Medicine CurrentSince Jun 2, 2018 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients

Locations

4211 Van Dyke Rd
Lutz, FL 33558
Phone (813) 265-6300

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

3001 W Mlk Blvd
Tampa, FL 33607
Phone (813) 361-6778

5802 N 30th St
Rm HS171
Tampa, FL 33610
Phone (813) 844-7100

2502 W Saint Isabel St
Tampa, FL 33607
Phone (813) 874-5707

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

4501 Bruce B Downs Blvd
Wesley Chapel, FL 33544
Phone (813) 870-4000

Organizations & group practices 6

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 1

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1619031267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 W SAINT ISABEL ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076318",
            "telephone_number": "813-874-5707",
            "fax_number": "813-874-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 W SAINT ISABEL ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076318",
            "telephone_number": "813-874-5707",
            "fax_number": "813-874-5908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12902 Usf Magnolia Dr",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336129416",
            "country_code": "US",
            "telephone_number": "813-745-0612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEILMAN",
        "first_name": "CLINTON",
        "middle_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "010240374",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME128366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.