Reem Ichoa, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS18140 Issued in FL

Practice address

12780 Race Track Rd Ste 205
Tampa, FL 33626-1395

Phone

(813) 792-8878

Fax

(813) 443-8171

NPI assigned

Apr 16, 2018

Last updated

May 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: reem.ichoa@direct.mybaycare.org
• Direct secure messaging: reem.ichoado@direct.mybaycare.org

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.

• Baycare Medical Group, Inc.

  • General Practice Physician
  • Clearwater, FL
  • NPI 1043269871
  Medicare reassignment NPD
• Baycare Medical Group, Inc

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1497117329
  NPD
• Baycare Medical Group, Inc.

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1659720837
  NPD

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1619464534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12780 RACE TRACK RD STE 205",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12780 RACE TRACK RD STE 205",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261395",
            "telephone_number": "813-792-8878",
            "fax_number": "813-443-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICHOA",
        "first_name": "REEM",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS18140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "reem.ichoa@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew St Fl 2",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337593012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tamara Ibrahim, MD
• Yasmine Ibrahim, MD
• Icare Tampa, LLC
• Amy Michelle Ice, MA, CRC
• Tara Marie Ice, NNP
• Icp Holdings, LLC (Carrollwood Compounding Center)
• Idea Public Schools Florida (IDEA Florida, INC)
• Ideal Body Institute Tampa ASC LLC (IBI Healthcare ASC)
• Ideal Body Institute Tampa, LLC
• Ideal Dental Carrollwood PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.