Individual provider Active NPI

Ammar Jesri, M.D.

  • Internal Medicine Physician
  • Lutz, FL
National Provider Identifier
1801965785
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME114199 Issued in FL
Practice address
4211 Van Dyke Rd
Suite 200
Lutz, FL 33558-8005
Phone
(813) 321-6237
Fax
(813) 463-1801
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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 ME114199 FL Primary

Addresses

Primary practice location

4211 Van Dyke Rd
Suite 200
Lutz, FL 33558-8005

Mailing address

4211 Van Dyke Rd Ste 200
Lutz, FL 33558-8005
Phone (813) 321-6237

Other identifiers 2

IdentifierTypeStateIssuer
P01478204OtherFLRAILROAD MEDICARE PROVIDER NUMBER
0090754-00MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ammar.JesriMD@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

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
I20130517000366 FL Practitioner - HospitalistPractitioner - Internal Medicine 3476602756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

4211 Van Dyke Rd
Lutz, FL 33558-8005

Hospital & facility affiliations

  • Baycare Home Care Inc Home health agency, Tampa, FL, CCN 107285
  • Baycare Home Care Inc Home health agency, New Port Richey, FL, CCN 107260
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Jun 11, 2014 Accepting new patients
Baycare Medical Group, Inc. Internal Medicine CurrentSince Jun 11, 2014 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

601 Main St
Dunedin, FL 34698
Phone (727) 461-1133

4211 Van Dyke Rd
#200
Lutz, FL 33558
Phone (813) 264-6490

4211 Van Dyke Rd
Ste 200
Lutz, FL 33558
Phone (813) 264-6490

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

6901 Simmons Loop
Fl 4
Riverview, FL 33578
Phone (813) 302-8388

3001 W Mlk Blvd
#3E
Tampa, FL 33607
Phone (813) 337-7535

Interoperability endpoints

  • Direct secure messaging: ammar.jesrimd@direct.mybaycare.org

Organizations & group practices 2

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 4

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1801965785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 VAN DYKE RD STE 200",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335588005",
            "telephone_number": "813-321-6237",
            "fax_number": "813-463-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 VAN DYKE RD",
            "address_2": "SUITE 200",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335588005",
            "telephone_number": "813-321-6237",
            "fax_number": "813-463-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESRI",
        "first_name": "AMMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME114199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDER NUMBER",
            "identifier": "P01478204",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0090754-00",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ammar.JesriMD@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew St Fl 2",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337593012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.