Individual provider Active NPI

Michael James Ferentino, P.A.

  • Medical Physician Assistant
  • Tampa, FL
National Provider Identifier
1750717377
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9107469 Issued in FL
Practice address
909 N Dale Mabry Hwy
Tampa, FL 33609-1251
Phone
(813) 978-9700
NPI assigned
Sep 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9107469 FL
Medical Physician Assistant 363AM0700X PA9107469 FL Primary

Addresses

Primary practice location

909 N Dale Mabry Hwy
Tampa, FL 33609-1251

Mailing address

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0915
Phone (813) 978-9700

Other identifiers 2

IdentifierTypeStateIssuer
019828800MedicaidFL
Y0L7KOtherFLFLORIDA BLUE

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
I20140204000575 FL Practitioner - Physician Assistant 5294964722 Reassigns benefits to 2 organizations

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

Practice addresses (Care Compare)

3334 Capital Medical Blvd
Suite 400
Tallahassee, FL 32308-4470
Phone (850) 877-8174

560 S Lakewood Dr
101 Florida Orthopaedic Institute
Brandon, FL 33511-5015
Phone (813) 978-9700

909 N Dale Mabry Hwy
Florida Orthopaedic Institute
Tampa, FL 33609-1251
Phone (813) 978-9700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9107469FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Sep 11, 2024 Accepting new patients
Tallahassee Orthopedic Clinic III PL CurrentSince Sep 11, 2024 Accepting new patients

Locations

560 S Lakewood Dr
Brandon, FL 33511
Phone (813) 657-8448

560 S Lakewood Dr
Ste 101
Brandon, FL 33511
Phone (813) 657-8448

2011 Harrison Ave
Panama City, FL 32405
Phone (850) 691-4188

803 W Main St
Perry, FL 32347
Phone (850) 584-7078

3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 210-1808

909 N Dale Mabry Hwy
Tampa, FL 33609
Phone (813) 287-9370

10740 Palm River Rd
Ste 300
Tampa, FL 33619
Phone (813) 651-3300

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

5901 E Fowler Ave
Ste 100
Temple Terrace, FL 33617
Phone (813) 987-9700

13020 N Telecom Pkwy
Temple Terrace, FL 33637

2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000

2653 Bruce B Downs Blvd
Fl Orthopaedic
Wesley Chapel, FL 33544

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: michael.ferentino.1@18802.direct.athenahealth.com

Organizations & group practices 3

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": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1750717377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370915",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091251",
            "telephone_number": "813-978-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERENTINO",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-16",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107469",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9107469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019828800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "Y0L7K",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.