Individual provider Active NPI

Michael Lee Caselnova, M.D.

  • Family Medicine Physician
  • Temple Terrace, FL
National Provider Identifier
1689696833
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 45762 Issued in FL
Practice address
12470 Telecom Dr Ste 100
Temple Terrace, FL 33637-0904
Phone
(813) 779-6303
Fax
(888) 977-1998
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11631 MT
Hospitalist Physician 208M00000X ME45762 FL
Family Medicine Physician 207Q00000X ME 45762 FL Primary

Addresses

Primary practice location

12470 Telecom Dr Ste 100
Temple Terrace, FL 33637-0904

Mailing address

12470 Telecom Dr Ste 100
Temple Terrace, FL 33637-0904
Phone (813) 779-6303

Other practice location 1

7209 Green Slope Dr
Zephyrhills, FL 33541-1306
Phone (615) 778-8517

Other identifiers 2

IdentifierTypeStateIssuer
080008869OtherFLRAILROAD WORKERS MEDICARE
045380300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, FL, GA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20090120000073 MT Practitioner - Family PracticePractitioner - Geriatric Medicine 6103989009 Reassigns benefits to 3 organizations
I20130625000598 FL Practitioner - Family Practice 6103989009 Reassigns benefits to 2 organizations
I20130716000301 GA Practitioner - Family Practice 6103989009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
University of South Florida College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cogent Healthcare of Montana P CGroup PAC ID 4486712833, 82 clinicians

Practice addresses (Care Compare)

2827 Fort Missoula Rd
Missoula, MT 59804-7408
Phone (406) 728-4100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 45762FLMDFamily Medicine Physician
11631MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Montana P C Family Medicine CurrentSince Apr 2, 2018 Accepting new patients
Pioneer Medical Group, PL Family Medicine CurrentSince Apr 1, 2018 Accepting new patients
Cogent Healthcare of Georgia PC Family Medicine CurrentSince Jul 6, 2013 Accepting new patients
Florida Hospital Physician Group Inc Family Medicine CurrentSince Apr 1, 2018 Accepting new patients
Hospitalist Medicine Physicians of Montana - TCS PC Family Medicine CurrentSince Feb 12, 2022 Accepting new patients
Inpatient Specialists of California, PC Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
Adventist Health System-Sunbelt Inc Family Medicine Past Accepting new patients
Central Montana Medical Facilities, Inc. Family Medicine Past Accepting new patients
Central Montana Medical Facilities, Inc Past Accepting new patients
Cogent Healthcare of North Carolina, PC Family Medicine Past Accepting new patients
St James Healthcare Past Accepting new patients

Locations

13100 Fort King Rd
Dade City, FL 33525
Phone (352) 521-1100

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

13067 N Telecom Pkwy
Temple Terrace, FL 33637
Phone (813) 333-9108

12470 Telecom Dr
Ste 100
Temple Terrace, FL 33637
Phone (813) 929-5454

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

38250 A Ave
Zephyrhills, FL 33542
Phone (813) 732-5608

6748 Gall Blvd
Ste 130
Zephyrhills, FL 33542
Phone (813) 780-9900

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

1233 N 30th St
Billings, MT 59101
Phone (406) 237-3850

400 S Clark St
Butte, MT 59701
Phone (406) 495-7260

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

Organizations & group practices 11

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 2

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1689696833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12470 TELECOM DR STE 100",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370904",
            "telephone_number": "813-779-6303",
            "fax_number": "888-977-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12470 TELECOM DR STE 100",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370904",
            "telephone_number": "813-779-6303",
            "fax_number": "888-977-1998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7209 Green Slope Dr",
            "address_purpose": "LOCATION",
            "city": "Zephyrhills",
            "state": "FL",
            "postal_code": "335411306",
            "country_code": "US",
            "telephone_number": "615-778-8517",
            "fax_number": "615-628-6877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASELNOVA",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "11631",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME45762",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 45762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD WORKERS MEDICARE",
            "identifier": "080008869",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045380300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.