Individual provider Active NPI

Gregory W Nestor, MD

  • Internal Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1639165863
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME46776 Issued in FL
Practice address
7655 38TH Ave N
Suite 202
St Petersburg, FL 33710-1263
Phone
(727) 547-0825
Fax
(727) 547-0523
NPI assigned
Sep 22, 2005
Last updated
Jan 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME46776 FL Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME46776 FL

Addresses

Primary practice location

7655 38TH Ave N
Suite 202
St Petersburg, FL 33710-1263

Mailing address

7655 38TH Ave N
Suite 202
St Petersburg, FL 33710-1263
Phone (727) 547-0825

Other identifiers 1

IdentifierTypeStateIssuer
062643100MedicaidFL

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
I20080918000349 FL Practitioner - Internal Medicine 0345317251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Florida College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 104TH Ave
Suite 1
Treasure Island, FL 33706-4846
Phone (727) 242-4049

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Medical Clinic LLC Past Accepting new patients
SC Physicians LLC Past Accepting new patients

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1639165863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7655 38TH AVE N",
            "address_2": "SUITE 202",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101263",
            "telephone_number": "727-547-0825",
            "fax_number": "727-547-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7655 38TH AVE N",
            "address_2": "SUITE 202",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101263",
            "telephone_number": "727-547-0825",
            "fax_number": "727-547-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESTOR",
        "first_name": "GREGORY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME46776",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME46776",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062643100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.