NPIMap

Individual provider Active NPI

Jason Christopher Stibich, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Brandon, FL
National Provider Identifier
1619905882
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
ME76668 Issued in FL
Practice address
500 Vonderburg Dr
Suite 311 West
Brandon, FL 33511-5964
Phone
(813) 654-2445
Fax
(813) 654-9885
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME76668 FL Primary

Addresses

Primary practice location

500 Vonderburg Dr
Suite 311 West
Brandon, FL 33511-5964

Mailing address

PO Box 242
Brandon, FL 33509-0242
Phone (813) 654-2445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111130000114 FL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 8820261522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
University of Missouri, Kansas City, School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brandon Area Primary Care PAGroup PAC ID 1759288269, 12 clinicians

Practice addresses (Care Compare)

500 Vonderburg Dr
Suite 311W
Brandon, FL 33511-5978
Phone (813) 654-2445

Hospital & facility affiliations

  • Baycare Home Care Inc Home health agency, Lakeland, FL, CCN 107282
  • Pinnacle Home Care Home health agency, Tampa, FL, CCN 683149
  • Trilogy Home Healthcare Home health agency, Tampa, FL, CCN 103145
  • Bon Secours Home Care by Compassus Home health agency, Sun City Center, FL, CCN 109645
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • HCA Florida South Shore Hospital Hospital, Sun City Center, FL, CCN 100259
  • H Lee Moffitt Cancer Center & Research Institute I Hospital, Tampa, FL, CCN 100271
  • Sun Terrace Health Care Center Nursing home, Sun City Center, FL, CCN 105319

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brandon Area Primary Care, PA CurrentSince Aug 20, 1998 Accepting new patients

Locations

282 Apollo Beach Blvd
Apollo Beach, FL 33572
Phone (813) 645-4068

500 Vonderburg Dr
Ste 311W
Brandon, FL 33511
Phone (813) 654-2445

Organizations & group practices 1

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 9

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1619905882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335090242",
            "telephone_number": "813-654-2445",
            "fax_number": "813-654-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VONDERBURG DR",
            "address_2": "SUITE 311 WEST",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115964",
            "telephone_number": "813-654-2445",
            "fax_number": "813-654-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIBICH",
        "first_name": "JASON",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME76668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.