Individual provider Active NPI

Nathan P Dean, MD

  • Pediatric Critical Care Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1710102652
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
ME150668 Issued in FL
Practice address
501 6TH Ave S
St Petersburg, FL 33701-4634
Phone
(727) 767-4343
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 2007013157 MO
Pediatric Critical Care Medicine Physician 2080P0203X ME150668 FL Primary

Addresses

Primary practice location

501 6TH Ave S
St Petersburg, FL 33701-4634

Mailing address

PO Box 37215
Baltimore, MD 21297-3215

Other practice location 1

111 Michigan Ave NW
Washington, DC 20010-2978
Phone (202) 476-6629

Other identifiers 1

IdentifierTypeStateIssuer
207283508MedicaidMO

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
I20240322003003 FL Practitioner - Critical Care (Intensivists) 0749372423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Wake Forest University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Physician Services, Inc.Group PAC ID 7113989849, 200 clinicians

Practice addresses (Care Compare)

601 5TH St S
Suite 5
St Petersburg, FL 33701-4804
Phone (727) 727-4429

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007013157MOMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Physician Services, Inc. CurrentSince Feb 1, 2024 Accepting new patients

Locations

601 5th St S
Ste 5
St Petersburg, FL 33701
Phone (727) 727-4429

501 6th Ave S
St Petersburg, FL 33701
Phone (727) 344-6060

Interoperability endpoints

  • Direct secure messaging: ndean863975@direct.hopkinsmedicine.org

Organizations & group practices 1

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1710102652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37215",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 6TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014634",
            "telephone_number": "727-767-4343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Michigan Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200102978",
            "country_code": "US",
            "telephone_number": "202-476-6629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAN",
        "first_name": "NATHAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "MO",
            "license": "2007013157",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME150668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207283508",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.