NPIMap

Individual provider Active NPI

Luby A Sidoff III, M.D.

  • Diagnostic Radiology Physician
  • St Petersburg, FL
National Provider Identifier
1801235627
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME136201 Issued in FL
Practice address
1200 7TH Ave N
St Petersburg, FL 33705-1300
Phone
(727) 825-1100
NPI assigned
Jun 14, 2013
Last updated
Aug 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD15058 RI
Diagnostic Radiology Physician 2085R0202X ME136201 FL Primary
Vascular & Interventional Radiology Physician 2085R0204X MD15058 RI

Addresses

Primary practice location

1200 7TH Ave N
St Petersburg, FL 33705-1300

Mailing address

PO Box 919379
Orlando, FL 32891-9379
Phone (844) 453-1406

Other practice location 1

1201 5th Ave N Ste 105
St Petersburg, FL 33705-1410
Phone (727) 825-1100

Other identifiers 4

IdentifierTypeStateIssuer
P02532303OtherFLFL RAILROAD MEDICARE PTAN
EYGWGOtherFLFL BCBS
025169800MedicaidFL
LN359OtherFLFL MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190204001266 FL Practitioner - Interventional Radiology 8022236041 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Imaging Associates LLCGroup PAC ID 2466342803, 182 clinicians
Radiology Associates of St Petersburg PAGroup PAC ID 2365413242, 26 clinicians
Baycare Outpatient Imaging LLCGroup PAC ID 3577804087, 90 clinicians
St Josephs Diagnostic Center LLCGroup PAC ID 3779484928, 89 clinicians
Stern Drake Isbell and Associates PAGroup PAC ID 3779480835, 57 clinicians
Peninsula Radiological Associates LimitedGroup PAC ID 5991603573, 64 clinicians

Practice addresses (Care Compare)

1041 Dunlawon Ave
Port Orange, FL 32127-7968
Phone (386) 274-7118

1200 7TH Ave N
St Petersburg, FL 33705-1300
Phone (727) 825-1100

1490 SE Magnolia Ext
Ocala, FL 34471-4443
Phone (352) 732-7400

2470 Bloomingdale Ave
Suite 115
Valrico, FL 33596-6403
Phone (727) 281-9390

3001 W MLK Blvd
Tampa, FL 33607-6307
Phone (813) 870-4000

3003 W Dr MLK Blvd
Tampa, FL 33607-6307
Phone (813) 870-4826

3202 N Park Rd
Plant City, FL 33563-2026
Phone (813) 757-1200

339 55TH Ave
St Pete Beach, FL 33706-2308
Phone (352) 351-7200

669 Coconut Palm Pkwy
Ponte Vedra, FL 32081-6079
Phone (757) 612-6999

6901 Simmons Loop
Riverview, FL 33578-9498
Phone (813) 302-8000

900 Carillon Pkwy
Saint Petersburg, FL 33716-1115
Phone (727) 561-2340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.9 of 100Reported as group
Quality
85.1
Improvement activities
40
Cost
80.55

Merit-based Incentive Payment System (MIPS)

Final score
98.12 of 100Reported as group
Quality
97.78
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.46 of 100Reported as group
Quality
89.95
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME136201FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Imaging Associates, LLC Multi-Specialty CurrentSince Jan 1, 2026 Accepting new patients
Peninsula Radiological Associates Limited Multi-Specialty CurrentSince May 2, 2024 Accepting new patients
Baycare Outpatient Imaging LLC Diagnostic Radiology CurrentSince Apr 1, 2025 Accepting new patients
Stern, Drake, Isbell & Associates, PA Multi-Specialty CurrentSince Apr 1, 2025 Accepting new patients
St. Anthony's Professional Buildings & Services, Inc Diagnostic Radiology CurrentSince Oct 29, 2018 Accepting new patients
Baycare Outpatient Imaging LLC Multi-Specialty CurrentSince Apr 1, 2025 Accepting new patients
Baycare Outpatient Imaging LLC Multi-Specialty Current Accepting new patients
St. Anthony's Professional Buildings & Services, Inc Multi-Specialty CurrentSince Oct 29, 2018 Accepting new patients
St Josephs Diagnostic Center LLC Multi-Specialty CurrentSince Apr 1, 2025 Accepting new patients
St. Anthony's Professional Buildings & Services, Inc Multi-Specialty Current Accepting new patients
St Joseph's Diagnostic Center LLC Multi-Specialty CurrentSince Apr 1, 2025 Accepting new patients
Rhode Island Medical Imaging Inc Multi-Specialty PastSince Jun 26, 2022 Accepting new patients

Locations

2995 Drew St
Bldg 2ND
Clearwater, FL 33759

18600 Fernview St
Ste 101
Land O Lakes, FL 34638
Phone (813) 692-8010

1490 SE Magnolia Ext
Ocala, FL 34471
Phone (352) 512-9703

1041 Dunlawton Ave
Pt Orange, FL 32127
Phone (386) 322-4700

1201 5th Ave N
Ste 105
St Petersburg, FL 33705

900 Carillon Pkwy
St Petersburg, FL 33716
Phone (727) 556-2662

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

3003 W Mlk Blvd
Tampa, FL 33607
Phone (813) 357-0630

4516 N Armenia Ave
Tampa, FL 33603
Phone (813) 348-6900

2470 Bloomingdale Ave
Ste 115
Valrico, FL 33596
Phone (727) 281-9390

500 J Clyde Morris Blvd
North North, VA 23601
Phone (757) 594-2000

19339 Benns Grant Blvd
Smithfield, VA 23430
Phone (757) 534-5000

120 Monticello Ave
Williamsburg, VA 23185
Phone (757) 564-3627

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 6

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": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1801235627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919379",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328919379",
            "telephone_number": "844-453-1406",
            "fax_number": "772-621-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 7TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051300",
            "telephone_number": "727-825-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 5th Ave N Ste 105",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337051410",
            "country_code": "US",
            "telephone_number": "727-825-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDOFF",
        "first_name": "LUBY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-14",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD15058",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME136201",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "RI",
            "license": "MD15058",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL RAILROAD MEDICARE PTAN",
            "identifier": "P02532303",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BCBS",
            "identifier": "EYGWG",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025169800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICARE PTAN",
            "identifier": "LN359",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.