Individual provider Active NPI

Phillip Daniel McConnell, MD

  • Emergency Medicine Physician
  • Tampa, FL
National Provider Identifier
1770873242
Registry record updated Jul 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME116429 Issued in FL
Practice address
2502 W Saint Isabel St
Suite B
Tampa, FL 33607-6370
Phone
(813) 874-5707
NPI assigned
Apr 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME116429 FL Primary

Addresses

Primary practice location

2502 W Saint Isabel St
Suite B
Tampa, FL 33607-6370

Mailing address

2502 W Saint Isabel St
Suite B
Tampa, FL 33607-6370
Phone (813) 874-5707

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
I20150731015577 FL Practitioner - Emergency Medicine 2062726235 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
East Tennessee State University Quillen College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guidewell Emergency Medicine Doctors, LLCGroup PAC ID 8224352919, 88 clinicians

Practice addresses (Care Compare)

113 N Orlando Ave
Winter Park, FL 32789-3675
Phone (407) 801-8400

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Observation Medical Group LLC Emergency Medicine CurrentSince Apr 1, 2016 Accepting new patients
Emergency Medical Associates of Tampa Bay, LLC Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients
Guidewell Emergency Medicine Doctors, LLC CurrentSince Oct 15, 2022 Accepting new patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Observation Medical Group LLC Emergency Medicine CurrentSince Apr 1, 2016 Accepting new patients
Guidewell Emergency Medicine Doctors, LLC CurrentSince Apr 6, 2025 Accepting new patients

Locations

4211 Van Dyke Rd
Lutz, FL 33558
Phone (813) 265-6300

2502 W Saint Isabel St
Ste B
Tampa, FL 33607
Phone (813) 873-7106

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

200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652

113 N Orlando Ave
Winter Park, FL 32789
Phone (407) 801-8400

Organizations & group practices 6

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": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437696000000",
    "number": "1770873242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 W SAINT ISABEL ST",
            "address_2": "SUITE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076370",
            "telephone_number": "813-874-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 W SAINT ISABEL ST",
            "address_2": "SUITE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076370",
            "telephone_number": "813-874-5707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "PHILLIP",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-18",
        "last_updated": "2015-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME116429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.