NPIMap

Organization Active NPI

Pinellas Primary Care Inc

  • Internal Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1639229842
Registry record updated Nov 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PINELLAS PRIMARY CARE INC
Practice address
2299 9TH Ave North
Ste 1F
St Petersburg, FL 33713-6851
Phone
(727) 323-9000
Fax
(727) 323-9100
NPI assigned
Jan 11, 2007
Last updated
Nov 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2008

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

Authorized official

Name
Jaysukhlal V Panara, MDNPI 1508934407
Title
Owner President
Phone
(727) 323-9000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

2299 9TH Ave North
Ste 1F
St Petersburg, FL 33713-6851

Mailing address

2299 9TH Ave North
Ste 1F
St Petersburg, FL 33713-6851
Phone (727) 323-9000

Other identifiers 1

IdentifierTypeStateIssuer
269655000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040712001443 FL Part B Supplier - Clinic/Group Practice 4284612524 Receives reassigned benefits from 2 practitioners
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

2299 9th Ave N
Ste 1F
St Petersburg, FL 33713
Phone (727) 323-9000

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227139200000",
    "number": "1639229842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2299 9TH AVE NORTH",
            "address_2": "STE 1F",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337136851",
            "telephone_number": "727-323-9000",
            "fax_number": "727-323-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2299 9TH AVE NORTH",
            "address_2": "STE 1F",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337136851",
            "telephone_number": "727-323-9000",
            "fax_number": "727-323-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINELLAS PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2008-11-20",
        "status": "A",
        "authorized_official_last_name": "PANARA",
        "authorized_official_first_name": "JAYSUKHLAL",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "727-323-9000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269655000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.