Individual provider Active NPI

Steven Arthur Dosal Jr., M.D.

  • Trauma Surgery Physician
  • Tampa, FL
National Provider Identifier
1780940783
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
ME136406 Issued in FL
Practice address
12901 Bruce B Downs Blvd
MDC 41
Tampa, FL 33612-4742
Phone
(813) 259-8510
Fax
(813) 259-0606
NPI assigned
Apr 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X ME136406 FL Primary

Addresses

Primary practice location

12901 Bruce B Downs Blvd
MDC 41
Tampa, FL 33612-4742

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other identifiers 2

IdentifierTypeStateIssuer
104332700MedicaidFL
PTC4FOtherFLBLUE CROSS BLUE SHIELD

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
I20190801002781 FL Practitioner - General SurgeryPractitioner - Internal Medicine 8820324577 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME136406FLMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59, LLC CurrentSince Dec 3, 2018 Accepting new patients
KND Development 59 LLC CurrentSince Dec 3, 2018 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Tampa General Hospital Current Accepting new patients

Locations

3030 6th St S
St Petersburg, FL 33705
Phone (727) 894-8719

4555 S Manhattan Ave
Tampa, FL 33611
Phone (813) 540-0093

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: sdosal55527@direct.tgh.org

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1780940783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD",
            "address_2": "MDC 41",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742",
            "telephone_number": "813-259-8510",
            "fax_number": "813-259-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOSAL",
        "first_name": "STEVEN",
        "middle_name": "ARTHUR",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "FL",
            "license": "ME136406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104332700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "PTC4F",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.