Active NPI
Mark Sam Stern, M.D.
- Internal Medicine Physician
- Tampa, FL
National Provider Identifier
1679538425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME 33074
- Practice address
- 5210 Interbay Blvd
Apt 9
Tampa, FL 33611-4145 - Phone
- (813) 334-2795
- Fax
- (813) 287-0671
- NPI assigned
- Apr 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME 33074 | FL | Primary |
Addresses
Primary practice location
5210 Interbay Blvd
Apt 9
Tampa, FL 33611-4145
Mailing address
5210 Interbay Blvd
Apt 9
Tampa, FL 33611-4145
Phone (813) 334-2795
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080623000240 | FL | Practitioner - Internal Medicine | 1254402035 | Practice locations: Tampa, FL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 33074 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465948800000",
"number": "1679538425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5210 INTERBAY BLVD",
"address_2": "APT 9",
"city": "TAMPA",
"state": "FL",
"postal_code": "336114145",
"telephone_number": "813-334-2795",
"fax_number": "813-287-0671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5210 INTERBAY BLVD",
"address_2": "APT 9",
"city": "TAMPA",
"state": "FL",
"postal_code": "336114145",
"telephone_number": "813-334-2795",
"fax_number": "813-287-0671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STERN",
"first_name": "MARK",
"middle_name": "SAM",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-17",
"last_updated": "2016-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME 33074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.