Individual provider Active NPI

Nikolaus Lee Gravenstein, M.D.

  • Anesthesiology Physician
  • Tampa, FL
National Provider Identifier
1760800569
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME135719 Issued in FL
Practice address
449 S 12TH St Unit 1003
Tampa, FL 33602-5608
Phone
(352) 494-0288
NPI assigned
Mar 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME135719 FL Primary

Addresses

Primary practice location

449 S 12TH St Unit 1003
Tampa, FL 33602-5608

Mailing address

2995 Drew St
Clearwater, FL 33759-3012
Phone (727) 315-7496

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
I20181126002067 FL Practitioner - Anesthesiology 6507086717 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Florida College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunshine State Anesthesia Partners LLCGroup PAC ID 8123434792, 429 clinicians

Practice addresses (Care Compare)

6500 38TH Ave N
St Petersburg, FL 33710-1629
Phone (727) 384-1414

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine State Anesthesia Partners LLC Anesthesiology CurrentSince Mar 20, 2024 Accepting new patients
American Anesthesiology Services of Florida, Inc. Anesthesiology CurrentSince Nov 7, 2018 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Nov 2, 2023 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Nov 2, 2023 Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2995 Drew St
Clearwater, FL 33759
Phone (727) 315-7496

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

6500 38th Ave N
St Petersburg, FL 33710
Phone (727) 341-4870

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

3003 W Mlk Blvd
Tampa, FL 33607
Phone (813) 357-0630

3001 W Mlk Blvd
Tampa, FL 33607
Phone (813) 361-6778

3030 W Mlk Blvd
Tampa, FL 33607
Phone (813) 870-4000

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 4

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 1

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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1760800569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-315-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 S 12TH ST UNIT 1003",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025608",
            "telephone_number": "352-494-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVENSTEIN",
        "first_name": "NIKOLAUS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME135719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.