Individual provider Active NPI

Yeshitila Agzew, MD

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1801813829
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0082835 Issued in FL
Practice address
19947 Tamiami Ave
Tampa, FL 33647
Phone
(813) 716-6959
Fax
(813) 929-7708
NPI assigned
Jul 16, 2006
Last updated
Jul 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0082835 FL Primary

Addresses

Primary practice location

19947 Tamiami Ave
Tampa, FL 33647

Mailing address

19947 Tamiami Ave
Tampa, FL 33647-3366
Phone (813) 716-6959

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
I20040325000742 FL Practitioner - Internal Medicine 8729970868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19947 Tamiami Ave
Tampa, FL 33647-3366
Phone (813) 716-6959

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0082835FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayshore Medical Group P L Internal Medicine CurrentSince Aug 1, 2008 Accepting new patients
Pinnacle Health Group PA Internal Medicine Past Accepting new patients
South Tampa Medical Associates Inc Internal Medicine Past Accepting new patients
South Tampa Medical Group PA Internal Medicine Past Accepting new patients

Locations

119 Oakfield Dr
Brandon, FL 33511
Phone (813) 571-5150

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1801813829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19947 TAMIAMI AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473366",
            "telephone_number": "813-716-6959",
            "fax_number": "813-929-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19947 TAMIAMI AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33647",
            "telephone_number": "813-716-6959",
            "fax_number": "813-929-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGZEW",
        "first_name": "YESHITILA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0082835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.