Individual provider Active NPI

Michael David Puchalski

  • Pediatric Cardiology Physician
  • St Petersburg, FL
National Provider Identifier
1639258106
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
ME146696 Issued in FL
Practice address
601 5TH St S
St Petersburg, FL 33701-4804
Phone
(727) 767-3333
NPI assigned
Nov 3, 2006
Last updated
Sep 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X C1-0030122 DE
Pediatric Cardiology Physician 2080P0202X ME146696 FL Primary
Pediatric Cardiology Physician 2080P0202X 341951-1205 UT

Addresses

Primary practice location

601 5TH St S
St Petersburg, FL 33701-4804

Mailing address

PO Box 581100
Salt Lake City, UT 84158-1100
Phone (801) 213-3900

Other practice location 1

PO Box 191
Rockland, DE 19732-0191
Phone (302) 651-6201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050418000446 UT Practitioner - Pediatric Medicine 3173561586 Reassigns benefits to 2 organizations
I20220118000600 FL Practitioner - Cardiovascular Disease (Cardiology) 3173561586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Wayne State University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Physician Services, Inc.Group PAC ID 7113989849, 200 clinicians

Practice addresses (Care Compare)

601 5TH St S
Suite 5
St Petersburg, FL 33701-4804
Phone (727) 727-4429

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME146696FLMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jun 29, 2010 Accepting new patients
Ihc Health Services Inc CurrentSince Jun 29, 2010 Accepting new patients
Tampa General Hospital Current Accepting new patients
University of Utah Pediatric Services CurrentSince Sep 1, 2016 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
University of Utah Pediatric Services CurrentSince Sep 1, 2016 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Pediatric Physician Services, Inc. Pediatric Cardiology CurrentSince Oct 13, 2021 Accepting new patients

Locations

501 6th Ave S
St Petersburg, FL 33701
Phone (727) 344-6060

601 5th St S
St Petersburg, FL 33701
Phone (727) 767-3333

601 5th St S
Ste 5
St Petersburg, FL 33701
Phone (727) 727-4429

1400 N 500 E
North Logan, UT 84341
Phone (435) 716-1000

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

81 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 662-5700

4401 Harrison Blvd
South Ogden, UT 84403
Phone (801) 387-2800

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: mpuchalski176268@direct.tgh.org
  • Direct secure messaging: mpuchalski741812@direct.hopkinsmedicine.org

Organizations & group practices 8

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1639258106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 581100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841581100",
            "telephone_number": "801-213-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-767-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 191",
            "address_purpose": "LOCATION",
            "city": "Rockland",
            "state": "DE",
            "postal_code": "197320191",
            "country_code": "US",
            "telephone_number": "302-651-6201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUCHALSKI",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "DE",
            "license": "C1-0030122",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME146696",
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "UT",
            "license": "341951-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.