NPIMap

Individual provider Active NPI

Juan Pedro Casadevalls, M.D.

  • Internal Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1669424123
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 67511 Issued in FL
Practice address
1201 5TH Ave N
Suite 410
St Petersburg, FL 33705-1433
Phone
(727) 822-5410
NPI assigned
May 16, 2006
Last updated
May 23, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 67511 FL Primary

Addresses

Primary practice location

1201 5TH Ave N
Suite 410
St Petersburg, FL 33705-1433

Mailing address

1201 5TH Ave N
Suite 410
St Petersburg, FL 33705-1433
Phone (727) 822-5410

Other identifiers 2

IdentifierTypeStateIssuer
273619500MedicaidFL
P00390046OtherFLRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050714000240 FL Practitioner - Internal Medicine 6103852827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westcoast Hospitalist LLCGroup PAC ID 5092819870, 4 clinicians

Practice addresses (Care Compare)

1200 7TH Ave N
St Petersburg, FL 33705-1300
Phone (727) 825-1100

1201 5TH Ave N
Suite 410
St Petersburg, FL 33705-1433

701 6TH St S
St Petersburg, FL 33701-4814
Phone (725) 825-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 67511FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westcoast Hospitalist LLC Internal Medicine CurrentSince Jan 25, 2007 Accepting new patients
St Anthony's Primary Care LLC Internal Medicine PastSince Sep 16, 2013 Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients

Locations

1201 5th Ave N
Ste 410
St Petersburg, FL 33705
Phone (727) 580-3719

1200 7th Ave N
St Petersburg, FL 33705
Phone (727) 820-7764

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.

Hospital & facility affiliations 8

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1669424123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE N",
            "address_2": "SUITE 410",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051433",
            "telephone_number": "727-822-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE N",
            "address_2": "SUITE 410",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051433",
            "telephone_number": "727-822-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASADEVALLS",
        "first_name": "JUAN",
        "middle_name": "PEDRO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 67511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273619500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00390046",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.