Individual provider Active NPI

Sherif Magdy Amin

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1629607239
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME158719 Issued in FL
Practice address
3128 E Hillsborough Ave
Tampa, FL 33610-4528
Phone
(813) 579-1769
Fax
(813) 305-7907
NPI assigned
Apr 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME158719 FL Primary

Addresses

Primary practice location

3128 E Hillsborough Ave
Tampa, FL 33610-4528

Mailing address

3128 E Hillsborough Ave
Tampa, FL 33610-4528
Phone (813) 579-1769

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
I20230620000933 FL Practitioner - Family Practice 3375967136 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME158719FLMDFamily Medicine Physician

Practice roles (3 of 5)

OrganizationSpecialtyStatusNew patients
Dedicated Senior Medical Center of Florida, LLC Current Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jul 1, 2023 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

3128 E Hillsborough Ave
Tampa, FL 33610
Phone (813) 579-1767

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1629607239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3128 E HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336104528",
            "telephone_number": "813-579-1769",
            "fax_number": "813-305-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3128 E HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336104528",
            "telephone_number": "813-579-1769",
            "fax_number": "813-305-7907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIN",
        "first_name": "SHERIF",
        "middle_name": "MAGDY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME158719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.