Individual provider Active NPI

Marquissa Beverly, DPM

  • Foot & Ankle Surgery Podiatrist
  • Tampa, FL
National Provider Identifier
1760764559
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO 3508 Issued in FL
Practice address
2835 West Deleon Street
#101
Tampa, FL 33609
Phone
(318) 792-2347
NPI assigned
Sep 16, 2011
Last updated
Nov 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO 3508 FL Primary

Addresses

Primary practice location

2835 West Deleon Street
#101
Tampa, FL 33609

Mailing address

205 S Moon Ave
Ste 101
Brandon, FL 33511-5716
Phone (813) 571-0123

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120411000242 FL Practitioner - Podiatry 4183885643 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pascarella Hoover Finkelstein and Wagner DPM PAGroup PAC ID 9436235645, 102 clinicians
Upperline Healthcare PCGroup PAC ID 4385900653, 194 clinicians

Practice addresses (Care Compare)

13049 Summerfield Square Dr
Riverview, FL 33578-7402
Phone (813) 945-9305

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue608
Removal or shaving of skin growth170
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO 3508FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ankle & Foot Center of Tampa Bay Foot & Ankle Surgery CurrentSince Apr 9, 2012 Accepting new patients
Ankle & Foot Center of Tampa Bay Foot & Ankle Surgery CurrentSince Apr 9, 2012 Accepting new patients
Upperline Healthcare, PC Foot & Ankle Surgery CurrentSince Nov 9, 2021 Accepting new patients
Upperline Healthcare, PC Foot & Ankle Surgery CurrentSince Nov 9, 2021 Accepting new patients
Pascarella, Hoover, Finkelstein, Wagner, DPM, PA CurrentSince Jan 15, 2025 Accepting new patients
Pascarella Hoover Finkelstein & Wagner DPM PA Foot & Ankle Surgery CurrentSince Jan 15, 2025 Accepting new patients
Ankle & Foot Center of Tampa Bay Foot & Ankle Surgery Past Accepting new patients

Locations

661 E Altamonte Dr
Ste 210
Altamonte Springs, FL 32701
Phone (407) 339-7759

205 S Moon Ave
Ste 101
Brandon, FL 33511
Phone (813) 571-0123

1700 N McMullen Booth Rd
Clearwater, FL 33759
Phone (727) 228-2388

1700 N McMullen Booth Rd
Ste A2-2
Clearwater, FL 33759
Phone (727) 725-2719

1700 N McMullen Booth Rd
Ste A2B
Clearwater, FL 33759
Phone (727) 725-2719

819 E Oak St
Ste B
Kissimmee, FL 34744
Phone (407) 846-1234

7350 Sandlake Commons Blvd
Ste 3329
Orlando, FL 32819
Phone (407) 345-5211

13049 Summerfield Square Dr
Riverview, FL 33578
Phone (813) 671-3100

13049 Summerfield Square Dr
Ste B
Riverview, FL 33578
Phone (813) 671-3100

13907 N Dale Mabry Hwy
Tampa, FL 33618
Phone (813) 963-1833

38105 13th Ave
Zephyrhills, FL 33542
Phone (813) 715-4747

4101 Charlotte Ave
Ste F185
Nashville, TN 37209
Phone (678) 426-2171

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: marquissa.beverly.1@4399.direct.athenahealth.com

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, 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": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1760764559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S MOON AVE",
            "address_2": "STE 101",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115716",
            "telephone_number": "813-571-0123",
            "fax_number": "813-661-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 WEST DELEON STREET",
            "address_2": "#101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33609",
            "telephone_number": "318-792-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVERLY",
        "first_name": "MARQUISSA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-16",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO 3508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.