Stefan Botha

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9119631 Issued in FL

Practice address

3301 W Gandy Blvd
Tampa, FL 33611-2931

Phone

(813) 925-1903

Fax

(813) 749-8370

NPI assigned

Dec 17, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synergic Healthcare Solutions LLCGroup PAC ID 7618235573, 94 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sbotha341552@direct.tgh.org
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Synergic Healthcare Solutions LLC

  • Urgent Care Clinic/Center
  • Tampa, FL
  • NPI 1063718013
  Medicare reassignment Care Compare group
• Synergic Healthcare Solutions LLC

  • Urgent Care Clinic/Center
  • Punta Gorda, FL
  • NPI 1174336119
  NPD
• Synergic Healthcare Solutions LLC

  • General Practice Physician
  • Wesley Chapel, FL
  • NPI 1194198382
  NPD
• Synergic Healthcare Solutions LLC

  • Urgent Care Clinic/Center
  • Lutz, FL
  • NPI 1558135814
  NPD
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1811583446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 TUCUMCARI TRL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342419118",
            "telephone_number": "210-264-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 W GANDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336112931",
            "telephone_number": "813-925-1903",
            "fax_number": "813-749-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTHA",
        "first_name": "STEFAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-17",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14092",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9119631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruben M Botello, DMD
• Alejandro Botero, PHARMD
• Carolina Botero, PHARMD
• Catalina Botero, D.D.S.
• Yohana Botero
• Aymen Botros
• Jennifer Botsch, LMHC
• Sisir Botta
• Kayla Botti, LCSW
• Salvatore Michael Bottiglieri, PHARM.D.

• Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.