NPIMap

Individual provider Active NPI

Thomas J Egan, MD

  • Diagnostic Radiology Physician
  • St Petersburg, FL
National Provider Identifier
1740296706
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME41215 Issued in FL
Practice address
1200 7TH Ave N
St Petersburg, FL 33705-1300
Phone
(727) 825-1100
Fax
(727) 827-5155
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X ME0041215 FL
Nuclear Radiology Physician 2085N0904X ME0041215 FL
Pediatric Radiology Physician 2085P0229X ME0041215 FL
Vascular & Interventional Radiology Physician 2085R0204X ME0041215 FL
Diagnostic Radiology Physician 2085R0202X ME0041215 FL
Diagnostic Radiology Physician 2085R0202X ME41215 FL Primary
Diagnostic Ultrasound Physician 2085U0001X ME0041215 FL

Addresses

Primary practice location

1200 7TH Ave N
St Petersburg, FL 33705-1300

Mailing address

PO Box 919379
Orlando, FL 32891-9379
Phone (844) 453-1406

Other practice location 1

1201 5th Ave N Ste 105
St Petersburg, FL 33705-1410
Phone (727) 825-1100

Other identifiers 4

IdentifierTypeStateIssuer
62407OtherFLFL BCBS
300003302OtherFLFL RAILROAD MEDICARE
046909200MedicaidFL
62407ZOtherFLFL MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050818000818 FL Practitioner - Diagnostic Radiology 3870523822 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of St Petersburg PAGroup PAC ID 2365413242, 26 clinicians
St Anthonys Professional Buildings and Services IncGroup PAC ID 6507849239, 27 clinicians

Practice addresses (Care Compare)

1200 7TH Ave N
St Petersburg, FL 33705-1300
Phone (727) 825-1100

900 Carillon Pkwy
Saint Petersburg, FL 33716-1115
Phone (727) 561-2340

Hospital & facility affiliations

  • St Anthonys Hospital Hospital, Saint Petersburg, FL, CCN 100067
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Merit-based Incentive Payment System (MIPS)

Final score
90.9 of 100Reported as group
Quality
85.1
Improvement activities
40
Cost
80.55

Merit-based Incentive Payment System (MIPS)

Final score
91.46 of 100Reported as group
Quality
89.95
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME41215FLMDDiagnostic Radiology Physician
ME0041215FLMDVascular & Interventional Radiology Physician

Practice roles (6 of 8)

OrganizationSpecialtyStatusNew patients
Radiology Associates of St. Petersburg PA Body Imaging CurrentSince Dec 14, 1982 Accepting new patients
St. Anthony'S Professional Buildings & Services, Inc Diagnostic Radiology CurrentSince Mar 23, 2010 Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients
MRI-South Umberton Inc Diagnostic Radiology Past Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients
Clearwater Resources Inc Diagnostic Radiology Past Accepting new patients

Locations

1201 5th Ave N
Ste 105
St Petersburg, FL 33705

1201 5th Ave N
Ste 104
St Petersburg, FL 33705

900 Carillon Pkwy
St Petersburg, FL 33716
Phone (727) 556-2662

1200 7th Ave N
St Petersburg, FL 33705
Phone (727) 820-7764

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St Anthonys HospitalSaint Petersburg, FL, CCN 100067 Hospital Corporate Director Nov 1, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1740296706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919379",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328919379",
            "telephone_number": "844-453-1406",
            "fax_number": "772-621-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 7TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051300",
            "telephone_number": "727-825-1100",
            "fax_number": "727-827-5155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 5th Ave N Ste 105",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337051410",
            "country_code": "US",
            "telephone_number": "727-825-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGAN",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "FL",
            "license": "ME0041215",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "FL",
            "license": "ME0041215",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "FL",
            "license": "ME0041215",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME0041215",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME0041215",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME41215",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "FL",
            "license": "ME0041215",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BCBS",
            "identifier": "62407",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL RAILROAD MEDICARE",
            "identifier": "300003302",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046909200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICARE PTAN",
            "identifier": "62407Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.