Individual provider Active NPI

Brendan Christopher O'Malley, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Tampa, FL
National Provider Identifier
1689641748
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
32917 Issued in FL
Practice address
13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone
(813) 615-7620
Fax
(813) 971-7953
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 32917 FL Primary

Addresses

Primary practice location

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905

Mailing address

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7625

Other identifiers 1

IdentifierTypeStateIssuer
208278100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32917FLMDEndocrinology, Diabetes & Metabolism Physician

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1689641748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13901 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133905",
            "telephone_number": "813-615-7625",
            "fax_number": "813-971-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13901 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133905",
            "telephone_number": "813-615-7620",
            "fax_number": "813-971-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "BRENDAN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "32917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208278100",
            "state": "FL"
        }
    ],
    "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 Jul 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.