Individual provider Active NPI

Tiffany R Burca, DO

  • Family Medicine Physician
  • Palm Harbor, FL
National Provider Identifier
1790071835
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS16999 Issued in FL
Practice address
35095 US Highway 19 N Ste 100
Palm Harbor, FL 34684-1968
Phone
(727) 953-8404
Fax
(813) 635-7866
NPI assigned
Jun 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS16999 FL Primary
Family Medicine Physician 207Q00000X DR.0059991 CO

Addresses

Primary practice location

35095 US Highway 19 N Ste 100
Palm Harbor, FL 34684-1968

Mailing address

35095 US Highway 19 N Ste 100
Palm Harbor, FL 34684-1968
Phone (727) 953-8404

Other practice location 1

4105 Briargate Pkwy Ste 125
Colorado Springs, CO 80920-3482
Phone (303) 338-4545

Other identifiers 3

IdentifierTypeStateIssuer
028853OtherCOKAISER COMMERCIAL NUMBER
PENDINGMedicaidFL
9000155034MedicaidCO

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
I20221204000032 FL Practitioner - Family Practice 6800144882 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS16999FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Jan 3, 2023 Accepting new patients
Baycare Medical Group, Inc Family Medicine CurrentSince Jan 3, 2023 Accepting new patients
Baycare Medical Group, Inc. Family Medicine Current 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

35095 US Highway 19 N
Ste 100
Palm Harbor, FL 34684
Phone (727) 953-8404

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.

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1790071835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35095 US HIGHWAY 19 N STE 100",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346841968",
            "telephone_number": "727-953-8404",
            "fax_number": "813-635-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35095 US HIGHWAY 19 N STE 100",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346841968",
            "telephone_number": "727-953-8404",
            "fax_number": "813-635-7866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4105 Briargate Pkwy Ste 125",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809203482",
            "country_code": "US",
            "telephone_number": "303-338-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURCA",
        "first_name": "TIFFANY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS16999",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0059991",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "028853",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000155034",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.