Organization Active NPI

Gerard C Mosiello MD PL

  • Specialist
  • Tampa, FL
National Provider Identifier
1700193893
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME79704 Issued in FL
Legal business name
GERARD C MOSIELLO MD PL
Practice address
15243 Amberly Dr
Tampa, FL 33647-2155
Phone
(813) 631-1500
Fax
(813) 631-1600
NPI assigned
Sep 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

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

Authorized official

Name
Dr. Gerard C Mosiello, MDNPI 1982687836
Title
Owner
Phone
(813) 890-8004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME79704 FL Primary

Addresses

Primary practice location

15243 Amberly Dr
Tampa, FL 33647-2155

Mailing address

15243 Amberly Dr
Tampa, FL 33647-2155
Phone (813) 631-1500

Other identifiers 1

IdentifierTypeStateIssuer
257027100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110511000477 FL Part B Supplier - Clinic/Group Practice 8426234295 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

15243 Amberly Dr
Tampa, FL 33647
Phone (813) 493-3376

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284076800000",
    "number": "1700193893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15243 AMBERLY DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472155",
            "telephone_number": "813-631-1500",
            "fax_number": "813-631-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15243 AMBERLY DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472155",
            "telephone_number": "813-631-1500",
            "fax_number": "813-631-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERARD C MOSIELLO MD PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-10",
        "last_updated": "2010-09-10",
        "status": "A",
        "authorized_official_last_name": "MOSIELLO",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-890-8004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME79704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257027100",
            "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 Sep 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.