Individual provider Active NPI

Josh Gilliam, PA-C

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1659535789
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104634 Issued in FL
Practice address
14547 Bruce B Downs Blvd
Tampa, FL 33613-2709
Phone
(813) 979-0440
Fax
(813) 355-5054
NPI assigned
Jul 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9104634 FL Primary

Addresses

Primary practice location

14547 Bruce B Downs Blvd
Tampa, FL 33613-2709

Mailing address

38135 Market SQ
Zephyrhills, FL 33542-7505
Phone (813) 528-4975

Other identifiers 2

IdentifierTypeStateIssuer
000340900MedicaidFL
P00982255OtherFLRR MEDICARE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081021000295 FL Practitioner - Physician Assistant 8325106362 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians
Sports and Orthopedic Rehabilitation Services IncGroup PAC ID 0840104253, shared by 4 NPIs, 314 clinicians

Practice addresses (Care Compare)

120 Charlois Blvd
Winston Salem, NC 27103-1562
Phone (336) 765-5664

14547 Bruce B Downs Blvd
Tampa, FL 33613-2709

2352 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9203

38101 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 715-0195

38103 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 778-0414

38105 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 815-5380

38107 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 979-0440

38135 Market Square Dr
Zephyrhills, FL 33542-7505

5347 Main St
Suite 202
New Port Richey, FL 34652-2520
Phone (727) 841-0515

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9104634FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Clinic, LLC CurrentSince Aug 4, 2008 Accepting new patients
Ohi West Medical Group II LLC CurrentSince Apr 1, 2024 Accepting new patients
Ohi West Medical Group II LLC CurrentSince Apr 1, 2024 Accepting new patients
Florida Medical Clinic LLC CurrentSince Aug 4, 2008 Accepting new patients
Ohi West Medical Group II LLC Past Accepting new patients

Locations

14547 Bruce B Downs Blvd
Tampa, FL 33613
Phone (800) 242-5080

14547 Bruce B Downs Blvd
Ste C
Tampa, FL 33613
Phone (813) 979-0440

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1659535789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "813-528-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14547 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336132709",
            "telephone_number": "813-979-0440",
            "fax_number": "813-355-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "JOSH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-17",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000340900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00982255",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.