Individual provider Active NPI

Brian J Deignan, MD

  • Pediatric Orthopaedic Surgery Physician
  • Tampa, FL
National Provider Identifier
1710184098
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
ME115264 Issued in FL
Practice address
3003 W Dr Martin Luther King Jr Blvd
Mab-3Rd Floor
Tampa, FL 33607-6307
Phone
(813) 554-8983
Fax
(813) 443-8177
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X ME115264 FL Primary

Addresses

Primary practice location

3003 W Dr Martin Luther King Jr Blvd
Mab-3Rd Floor
Tampa, FL 33607-6307

Mailing address

PO Box 743409
Atlanta, GA 30374-3409
Phone (727) 532-0002

Other identifiers 1

IdentifierTypeStateIssuer
0087555-00MedicaidFL

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
I20130712000686 FL Practitioner - Orthopedic Surgery 4981844057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Miami, LM Miller School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone (813) 321-6589

3003 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince May 1, 2015 Accepting new patients
Baycare Medical Group, Inc. Current Accepting new patients
Baycare Medical Group, Inc CurrentSince May 1, 2015 Accepting new patients
Baycare Medical Group Pediatric Walk-in Care LLC Past Accepting new patients
Baycare Medical Group Pediatric Walk-in, LLC Past Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

10141 Big Bend Rd
Ste 101
Riverview, FL 33578
Phone (813) 397-1270

10141 Big Bend Rd
Ste 206
Riverview, FL 33578
Phone (813) 321-6580

3003 W Mlk Blvd
Tampa, FL 33607
Phone (813) 357-0630

3003 W Mlk Blvd
Fl 3
Tampa, FL 33607
Phone (813) 554-8701

Interoperability endpoints

  • Direct secure messaging: brian.deignanj@direct.mybaycare.org

Organizations & group practices 5

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1710184098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743409",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743409",
            "telephone_number": "727-532-0002",
            "fax_number": "727-532-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 W DR MARTIN LUTHER KING JR BLVD",
            "address_2": "MAB-3RD FLOOR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076307",
            "telephone_number": "813-554-8983",
            "fax_number": "813-443-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIGNAN",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "FL",
            "license": "ME115264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0087555-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.