Individual provider Active NPI

David Mark Mokotoff, MD

  • Cardiovascular Disease Physician
  • St Petersburg, FL
National Provider Identifier
1720071004
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME39843 Issued in FL
Practice address
5398 Park St N
St Petersburg, FL 33709-1041
Phone
(727) 544-1441
Fax
(727) 545-8263
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME39843 FL Primary

Addresses

Primary practice location

5398 Park St N
St Petersburg, FL 33709-1041

Mailing address

5398 Park St N
St Petersburg, FL 33709-1041
Phone (727) 544-1441

Other identifiers 1

IdentifierTypeStateIssuer
066384100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1720071004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5398 PARK ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337091041",
            "telephone_number": "727-544-1441",
            "fax_number": "727-545-8263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5398 PARK ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337091041",
            "telephone_number": "727-544-1441",
            "fax_number": "727-545-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOKOTOFF",
        "first_name": "DAVID",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME39843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066384100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.