Individual provider Active NPI

Alan M Weintraub, MD

  • Gastroenterology Physician
  • Tampa, FL
National Provider Identifier
1780609065
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME59366 Issued in FL
Practice address
4108 Henderson Blvd
Tampa, FL 33629-5750
Phone
(813) 289-4321
Fax
(813) 247-2949
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME59366 FL Primary

Addresses

Primary practice location

4108 Henderson Blvd
Tampa, FL 33629-5750

Mailing address

3001 Executive Dr Ste 130
Clearwater, FL 33762-5323
Phone (727) 347-0005

Other identifiers 4

IdentifierTypeStateIssuer
11969OtherFLBCBS
052618500MedicaidFL
0004389OtherFLUNITED
110178341OtherFLRAILROAD

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
I20100902000291 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 3173570330 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Miami, LM Miller School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Central Gastroenterology LLPGroup PAC ID 0648322362, 82 clinicians
Whitaker,Weintraub and Grizzard, MD,PAGroup PAC ID 1456329986, 5 clinicians

Practice addresses (Care Compare)

4108 Henderson Blvd
Tampa, FL 33629-5750
Phone (813) 289-4321

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy89
Upper gastrointestinal (GI) endoscopy for acid reflux49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Central Gastroenterology LLP Gastroenterology CurrentSince Dec 1, 2014 Accepting new patients
Whitaker,Weintraub & Grizzard, MD,PA Gastroenterology CurrentSince Mar 1, 1999 Accepting new patients
John Q Stauffer Mdpa Gastroenterology Past Accepting new patients
Gastro Florida Pharmacy, LLC PastSince Dec 15, 2019 Accepting new patients

Locations

3001 Executive Dr
Ste 130
Clearwater, FL 33762
Phone (727) 329-3371

6225 66th St N
Pinellas Park, FL 33781
Phone (727) 521-0994

4108 Henderson Blvd
Tampa, FL 33629
Phone (813) 289-4321

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1780609065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 EXECUTIVE DR STE 130",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337625323",
            "telephone_number": "727-347-0005",
            "fax_number": "275-416-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4108 HENDERSON BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295750",
            "telephone_number": "813-289-4321",
            "fax_number": "813-247-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINTRAUB",
        "first_name": "ALAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME59366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "11969",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052618500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "0004389",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "110178341",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.