Individual provider Active NPI

Loren E Isakson, MD

  • Allergy & Immunology Physician
  • Saint Petersburg, FL
National Provider Identifier
1730201674
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
ME110222 Issued in FL
Practice address
900 Carillon Pkwy Ste 301
Saint Petersburg, FL 33716-1115
Phone
(727) 222-1879
Fax
(855) 853-7314
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 243002 NY
Allergy & Immunology Physician 207K00000X 066845 GA
Allergy & Immunology Physician 207K00000X ME110222 FL Primary

Addresses

Primary practice location

900 Carillon Pkwy Ste 301
Saint Petersburg, FL 33716-1115

Mailing address

2655 Ulmerton Rd # 225
Clearwater, FL 33762-3337
Phone (727) 222-1879

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
I20200331002706 FL Practitioner - Allergy/Immunology 2860821535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

900 Carillon Pkwy
Suite 301
St Petersburg, FL 33716-1115
Phone (727) 222-1879

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME110222FLMDAllergy & Immunology Physician
066845GAMDAllergy & Immunology Physician
243002NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Star Allergy, Asthma, & Immunology, P.a. Allergy & Immunology CurrentSince Mar 1, 2020 Accepting new patients

Locations

2655 Ulmerton Rd
Clearwater, FL 33762
Phone (443) 625-5439

900 Carillon Pkwy
Ste 301
St Petersburg, FL 33716
Phone (727) 222-1879

Interoperability endpoints

  • Direct secure messaging: loren.isakson.1@20441.direct.athenahealth.com

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1730201674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 ULMERTON RD # 225",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337623337",
            "telephone_number": "727-222-1879",
            "fax_number": "855-853-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CARILLON PKWY STE 301",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337161115",
            "telephone_number": "727-222-1879",
            "fax_number": "855-853-7314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAKSON",
        "first_name": "LOREN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "243002",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "GA",
            "license": "066845",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME110222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

Verify at the official NPI Registry.