Individual provider Active NPI

Bill Foo, M.D.

  • Pediatrics Physician
  • Riverview, FL
National Provider Identifier
1679951347
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME157305 Issued in FL
Practice address
10729 Queens Town Dr
Riverview, FL 33579-7186
Phone
(813) 672-3497
Fax
(813) 741-2418
NPI assigned
May 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME157305 FL
Pediatrics Physician 208000000X A155650 CA
Pediatrics Physician 208000000X ME157305 FL Primary

Addresses

Primary practice location

10729 Queens Town Dr
Riverview, FL 33579-7186

Mailing address

720 Brooker Creek Blvd Ste 215
Oldsmar, FL 34677-2937
Phone (813) 854-2003

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
I20221011001086 FL Practitioner - HospitalistPractitioner - Pediatric Medicine 9739494790 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A155650CAMDPediatrics Physician
ME157305FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Health Care Alliance, PA Pediatrics CurrentSince Oct 6, 2024 Accepting new patients
Pediatric Physician Services, Inc. Pediatrics CurrentSince Oct 10, 2022 Accepting new patients
Pediatric Health Care Alliance, PA Pediatrics PastSince Oct 6, 2024 Accepting new patients

Locations

720 Brooker Creek Blvd
Ste 215
Oldsmar, FL 34677
Phone (813) 854-2003

10729 Queens Town Dr
Riverview, FL 33579
Phone (813) 672-3497

601 5th St S
Ste 5
St Petersburg, FL 33701
Phone (727) 727-4429

501 6th Ave S
St Petersburg, FL 33701
Phone (727) 344-6060

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1679951347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 BROOKER CREEK BLVD STE 215",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346772937",
            "telephone_number": "813-854-2003",
            "fax_number": "813-436-5378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10729 QUEENS TOWN DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335797186",
            "telephone_number": "813-672-3497",
            "fax_number": "813-741-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOO",
        "first_name": "BILL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-13",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME157305",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A155650",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME157305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.