Individual provider Active NPI

Tammy Lin Hieber, AGPCNP

  • Gerontology Nurse Practitioner
  • Pinellas Park, FL
National Provider Identifier
1720599046
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
9228271 Issued in FL
Practice address
9895 66TH Way N
Pinellas Park, FL 33782-2941
Phone
(727) 505-5616
NPI assigned
Oct 12, 2017
Last updated
Oct 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 9228271 FL Primary

Addresses

Primary practice location

9895 66TH Way N
Pinellas Park, FL 33782-2941

Mailing address

9895 66TH Way N
Pinellas Park, FL 33782-2941
Phone (727) 505-5616

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
I20181228002496 FL Practitioner - Nurse Practitioner 3476898016 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Value Based Long Term Care F PCGroup PAC ID 2769922731, 18 clinicians
Legacy Health Medical Group, LLCGroup PAC ID 5193962173, 17 clinicians

Practice addresses (Care Compare)

801 W Bay Dr
Suite 605
Largo, FL 33770-3268
Phone (727) 489-3305

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9228271FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Value Based Long Term Care F PC CurrentSince Apr 19, 2025 Accepting new patients
Careconnectmd Florida P.a. CurrentSince Aug 1, 2024 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

5 Research Dr
Shelton, CT 06484
Phone (203) 567-5264

801 West Bay Dr
Ste 605
Largo, FL 33770
Phone (727) 489-3305

Interoperability endpoints

  • Direct secure messaging: thieber188934@orlandohealth.medalliesdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1720599046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9895 66TH WAY N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337822941",
            "telephone_number": "727-505-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9895 66TH WAY N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337822941",
            "telephone_number": "727-505-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIEBER",
        "first_name": "TAMMY",
        "middle_name": "LIN",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "9228271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

Verify at the official NPI Registry.