Individual provider Active NPI

Mildred E. Pazmino-Vera, M.D.

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1639125107
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME68352 Issued in FL
Practice address
3675 W Waters Ave
Tampa, FL 33614-2783
Phone
(813) 915-2000
Fax
(813) 930-6360
NPI assigned
May 26, 2006
Last updated
Jun 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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 ME68352 FL Primary

Addresses

Primary practice location

3675 W Waters Ave
Tampa, FL 33614-2783

Mailing address

10051 5TH St N Ste 200
St Petersburg, FL 33702-2211
Phone (727) 824-0780

Other identifiers 2

IdentifierTypeStateIssuer
263816900MedicaidFL
080097670OtherFLRAILROAD MEDICARE NUMBER

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
I20100114000773 FL Practitioner - Family Practice 0042352957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

2122 US-19 Alt B
Optum Palm Harbor
Palm Harbor, FL 34683-5357
Phone (727) 942-8900

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida LLC Family Medicine CurrentSince Jan 6, 2020 Accepting new patients
Optumcare Florida, LLC CurrentSince Jan 6, 2020 Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients

Locations

1989 W Lumsden Rd
Brandon, FL 33511
Phone (813) 653-3111

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

2122 Palm Harbor Blvd
Ste B
Palm Harbor, FL 34683
Phone (727) 785-1998

10051 5th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 828-2370

3675 W Waters Ave
Tampa, FL 33614
Phone (813) 915-2000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mildred.pazminovera@wellmed.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1639125107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 5TH ST N STE 200",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022211",
            "telephone_number": "727-824-0780",
            "fax_number": "813-930-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 W WATERS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142783",
            "telephone_number": "813-915-2000",
            "fax_number": "813-930-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAZMINO-VERA",
        "first_name": "MILDRED",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME68352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263816900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "080097670",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.