Individual provider Active NPI

Mara Angelie Pallens, M.D.

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1699942359
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME130470 Issued in FL
Practice address
400 N Ashley Dr
Ste 1625
Tampa, FL 33602-4300
Phone
(813) 289-6597
Fax
(865) 769-3454
NPI assigned
May 13, 2008
Last updated
Dec 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME130470 FL Primary
Infectious Disease Physician 207RI0200X 20584 PR

Addresses

Primary practice location

400 N Ashley Dr
Ste 1625
Tampa, FL 33602-4300

Mailing address

400 N Ashley Dr
Ste 1625
Tampa, FL 33602-4300
Phone (813) 289-6597

Other names 1

  • Dr. Mara Angelie Pallens-Feliciano Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20151009000961 PR Practitioner - Infectious DiseasePractitioner - Internal Medicine 6709192420 Practice locations: Ponce, PR
I20170315000689 FL Practitioner - Internal Medicine 6709192420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ponce School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1431 SW 1St Ave
Ocala, FL 34471-6500
Phone (352) 401-1000

3030 W Bearss Ave
Tampa, FL 33618-1811
Phone (813) 968-8777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20584PRMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc Internal Medicine Current Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Dec 15, 2016 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Dec 15, 2016 Accepting new patients

Locations

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1699942359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N ASHLEY DR",
            "address_2": "STE 1625",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024300",
            "telephone_number": "813-289-6597",
            "fax_number": "865-769-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N ASHLEY DR",
            "address_2": "STE 1625",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024300",
            "telephone_number": "813-289-6597",
            "fax_number": "865-769-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLENS",
        "first_name": "MARA",
        "middle_name": "ANGELIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-13",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME130470",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PR",
            "license": "20584",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARA",
            "last_name": "PALLENS-FELICIANO",
            "middle_name": "ANGELIE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.