Individual provider Active NPI

Ailin Pournouri, DO

  • Internal Medicine Physician
  • Safety Harbor, FL
National Provider Identifier
1770161796
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS20231 Issued in FL
Practice address
1840 Mease Dr Ste 404
Safety Harbor, FL 34695-6606
Phone
(727) 712-0980
Fax
(813) 635-2694
NPI assigned
Mar 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS20231 FL Primary

Addresses

Primary practice location

1840 Mease Dr Ste 404
Safety Harbor, FL 34695-6606

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 315-7496

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ailin.PournouriMD@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

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
I20240909000147 FL Practitioner - Internal Medicine 0143620963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

1840 Mease Dr
Safety Harbor, FL 34695-6606

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

2985 Drew St
Clearwater, FL 33759-3012
Phone (727) 467-4860

2995 Drew St
FL 2
Clearwater, FL 33759-3012
Phone (727) 281-9390

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS20231FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Internal Medicine Current Accepting new patients
Baycare Medical Group, Inc. CurrentSince Aug 29, 2024 Accepting new patients
Baycare Medical Group, Inc CurrentSince Aug 29, 2024 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

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

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

1840 Mease Dr
Ste 404
Safety Harbor, FL 34695
Phone (727) 712-0980

Interoperability endpoints

  • Direct secure messaging: ailin.pournourimd@direct.mybaycare.org

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.

Hospital & facility affiliations 4

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": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1770161796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 2",
            "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": "1840 MEASE DR STE 404",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346956606",
            "telephone_number": "727-712-0980",
            "fax_number": "813-635-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURNOURI",
        "first_name": "AILIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS20231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ailin.PournouriMD@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1840 Mease Dr Ste 404",
            "city": "Safety Harbor",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346956606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Safety Harbor, FL

Sources for this page

Verify at the official NPI Registry.