Individual provider Active NPI

Monica M. Clemente-Ortiz, MD

  • General Practice Physician
  • St Petersburg, FL
National Provider Identifier
1710093075
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN708 Issued in FL
Practice address
780 4TH Ave S
St Petersburg, FL 33701-4412
Phone
(727) 502-0052
Fax
(727) 502-0057
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN708 FL Primary

Addresses

Primary practice location

780 4TH Ave S
St Petersburg, FL 33701-4412

Mailing address

6101 Webb Rd Ste 203
Tampa, FL 33615-2865
Phone (813) 610-9031

Other practice location 1

6637 49th St N
Pinellas Park, FL 33781-5728
Phone (727) 528-8000

Other identifiers 1

IdentifierTypeStateIssuer
ACN708OtherFLMEDICAL LICENSE NUMBER

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
I20151117001871 FL Practitioner - General Practice 5799005377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of Puerto Rico School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Best Value Healthcare LLC 56 clinicians

Practice addresses (Care Compare)

6101 Webb Rd
Suite 104
Tampa, FL 33615-2859
Phone (813) 290-0422

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN708FLMDGeneral Practice Physician

Practice roles (3 of 5)

OrganizationSpecialtyStatusNew patients
Best Value Healthcare LLC CurrentSince Aug 1, 2021 Accepting new patients
Best Value Healthcare LLC PastSince Jun 27, 2021 Accepting new patients
Medical Home Alliance LLC Past Accepting new patients

Locations

3800 E Bay Dr
Largo, FL 33771
Phone (727) 539-0505

6637 49th St N
Pinellas Park, FL 33781
Phone (727) 502-0052

601 7th St S
Ste 530
St Petersburg, FL 33701
Phone (727) 322-4228

780 4th Ave S
St Petersburg, FL 33701
Phone (727) 502-0052

6101 Webb Rd
Ste 104
Tampa, FL 33615
Phone (813) 290-0422

6101 Webb Rd
Ste 203
Tampa, FL 33615
Phone (813) 884-4794

1501 Presidential Way
Ste 12
West Palm Beach, FL 33401
Phone (407) 471-9484

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1710093075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 WEBB RD STE 203",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336152865",
            "telephone_number": "813-610-9031",
            "fax_number": "877-868-5943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 4TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014412",
            "telephone_number": "727-502-0052",
            "fax_number": "727-502-0057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6637 49th St N",
            "address_purpose": "LOCATION",
            "city": "Pinellas Park",
            "state": "FL",
            "postal_code": "337815728",
            "country_code": "US",
            "telephone_number": "727-528-8000",
            "fax_number": "727-528-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMENTE-ORTIZ",
        "first_name": "MONICA",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2023-03-07",
        "certification_date": "2021-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "ACN708",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.