Individual provider Active NPI

Shazia Mitha, MPHIL, AGACNP-BC, RN

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1669921813
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11011268 Issued in FL
Practice address
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone
(813) 745-4673
Fax
(813) 449-8618
NPI assigned
Sep 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11011268 FL Primary

Addresses

Primary practice location

12902 Usf Magnolia Dr
Tampa, FL 33612-9416

Mailing address

PO Box 198441
Atlanta, GA 30384-8441
Phone (813) 745-4673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL, AR3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210922003002 NY Practitioner - Nurse Practitioner 9931506615 Reassigns benefits to 1 organization
I20220409000423 FL Practitioner - Nurse Practitioner 9931506615 Reassigns benefits to 2 organizations
I20240307003277 AR Practitioner - Nurse Practitioner 9931506615 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778

6901 Simmons Loop
Suite 4
Riverview, FL 33578-9498
Phone (813) 332-1734

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Icp Arkansas Aco Billing LLC CurrentSince Feb 23, 2024 Accepting new patients
Baycare Medical Group, Inc. Nurse Practitioner Current Accepting new patients
North Shore-Lij Medical PC CurrentSince Jun 22, 2021 Accepting new patients
Integrated Care Professionals, LLC CurrentSince Feb 23, 2024 Accepting new patients
Baycare Medical Group, Inc CurrentSince Sep 3, 2024 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Sep 3, 2024 Accepting new patients

Locations

200 River Market Ave
Ste 500
Little Rock, AR 72201
Phone (501) 492-0099

200 River Market Ave
Ste 100
Little Rock, AR 72201
Phone (501) 267-9870

2995 Drew St
Clearwater, FL 33759
Phone (727) 315-7496

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

6901 Simmons Loop
Fl 4
Riverview, FL 33578
Phone (813) 302-8388

4620 N Habana Ave
Ste 102
Tampa, FL 33614
Phone (727) 723-5060

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

972 Brush Hollow Rd
Westbury, NY 11590

Organizations & group practices 7

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 3

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": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1669921813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198441",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848441",
            "telephone_number": "813-745-4673",
            "fax_number": "813-449-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129416",
            "telephone_number": "813-745-4673",
            "fax_number": "813-449-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITHA",
        "first_name": "SHAZIA",
        "credential": "MPHIL, AGACNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11011268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.