Individual provider Active NPI

Amy Lynne Bearison

  • Pediatrics Physician
  • Tampa, FL
National Provider Identifier
1669935144
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME155973 Issued in FL
Practice address
1919 W Swann Ave
Tampa, FL 33606-2417
Phone
(813) 254-7079
Fax
(813) 443-8164
NPI assigned
Apr 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X ME155973 FL Primary

Addresses

Primary practice location

1919 W Swann Ave
Tampa, FL 33606-2417

Mailing address

1919 W Swann Ave
Tampa, FL 33606-2417
Phone (813) 254-7079

Other practice location 1

200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 899-9511

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amy.bearisonMD@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220510001485 FL Practitioner - Pediatric Medicine 4082091244 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince May 3, 2022 Accepting new patients
Baycare Medical Group, Inc. CurrentSince May 3, 2022 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

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

1919 W Swann Ave
Fl 2
Tampa, FL 33606
Phone (813) 254-7078

Interoperability endpoints

  • Direct secure messaging: amy.bearisonmd@direct.mybaycare.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1669935144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 W SWANN AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062417",
            "telephone_number": "813-254-7079",
            "fax_number": "813-443-8164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 W SWANN AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062417",
            "telephone_number": "813-254-7079",
            "fax_number": "813-443-8164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Henry Clay Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701185720",
            "country_code": "US",
            "telephone_number": "504-899-9511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEARISON",
        "first_name": "AMY",
        "middle_name": "LYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME155973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.bearisonMD@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew St Fl 2",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337593012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.