Individual provider Active NPI

Brian G Hamilton, PAC

  • Surgical Physician Assistant
  • Tampa, FL
National Provider Identifier
1720413537
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9107445 Issued in FL
Practice address
12880 Commodity PL
Tampa, FL 33626-3101
Phone
(813) 343-5500
Fax
(866) 462-7445
NPI assigned
Sep 11, 2013
Last updated
Apr 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9107445 FL Primary

Addresses

Primary practice location

12880 Commodity PL
Tampa, FL 33626-3101

Mailing address

PO Box 21686
Tampa, FL 33622-1686
Phone (813) 343-5500

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131029000780 FL Practitioner - Physician Assistant 8527293513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joseph Spine PAGroup PAC ID 2860773017, 10 clinicians

Practice addresses (Care Compare)

2727 W Dr Martin Luther King Jr Blvd
Suite 590
Tampa, FL 33607-6000
Phone (813) 534-6269

2727 W Dr MLK Jr Blvd
Suite 590
Tampa, FL 33607-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vero Orthopaedics II PA PastSince Aug 28, 2021 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1720413537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21686",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336221686",
            "telephone_number": "813-343-5500",
            "fax_number": "866-462-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12880 COMMODITY PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336263101",
            "telephone_number": "813-343-5500",
            "fax_number": "866-462-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "BRIAN",
        "middle_name": "G",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-11",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9107445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.