Alexandria S. Kongsiri, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME83035 Issued in FL

Practice address

5253 Central Ave
Saint Petersburg, FL 33710-8141

Phone

(727) 388-6982

Fax

(727) 323-7001

NPI assigned

Sep 15, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Dermatology

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Visage Dermatology, LLCGroup PAC ID 2163420621, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.75 of 100Reported as individual

Quality

85.51

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: akongsiri@directaddress.net

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.

• Visage Dermatology, LLC

  • Specialist
  • St Petersburg, FL
  • NPI 1932200045

  Dermatology

  Medicare reassignment Care Compare group NPD Authorized official
• K Wade Foster MD PA

  • MOHS-Micrographic Surgery Physician
  • Winter Haven, FL
  • NPI 1205066404
  NPD (past)
• Suncoast Medical Clinic LLC

  • Multi-Specialty Clinic/Center
  • St Petersburg, FL
  • NPI 1497866537
  NPD (past)
• Suncoast Medical Clinic LLC

  • Clinical Medical Laboratory
  • St Petersburg, FL
  • NPI 1649397662
  NPD (past)
• Suncoast Medical Clinic LLC

  • Durable Medical Equipment & Medical Supplies
  • St Petersburg, FL
  • NPI 1760664882
  NPD (past)

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1740275791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5253 CENTRAL AVE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337108141",
            "telephone_number": "727-388-6982",
            "fax_number": "727-323-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5253 CENTRAL AVE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337108141",
            "telephone_number": "727-388-6982",
            "fax_number": "727-323-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONGSIRI",
        "first_name": "ALEXANDRIA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2022-05-20",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME83035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262172000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tejal Kolwankar
• Kona 66 LLC
• Kona Gardens LLC
• Natasa Koncar, PHARMD
• Gianna Kondzielawa
• Katia Konicek-Stetor, APRN
• Pete Konidas, PHARM. D.
• Paola Margarita Kontrick, LMT
• Jeff D Kopelman, DPM
• Ravikiran Korabathina, M.D.

• Dermatology Physician in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.