Individual provider Active NPI

Brian Pink, MD

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1821626607
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME162231 Issued in FL
Practice address
3131 N McMullen Booth Rd
Clearwater, FL 33761-2008
Phone
(855) 834-6911
NPI assigned
Mar 29, 2020
Last updated
Mar 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME162231 FL Primary

Addresses

Primary practice location

3131 N McMullen Booth Rd
Clearwater, FL 33761-2008

Mailing address

3515 NW 50TH Ave
Gainesville, FL 32605-1067
Phone (717) 809-9330

Other practice location 1

2020 Ashley Oaks Cir
Wesley Chapel, FL 33544-6410
Phone (855) 834-6911

Other practice location 2

2815 W Virginia Ave
Tampa, FL 33607-6357
Phone (855) 834-6911

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
I20230825000752 FL Practitioner - Family Practice 0547664427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chris Pittman MD PAGroup PAC ID 9234311127, 3 clinicians

Practice addresses (Care Compare)

2815 W Virginia Ave
Suite a
Tampa, FL 33607-6357
Phone (855) 834-6911

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal691

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME162231FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chris Pittman MD PA Single Specialty CurrentSince Aug 7, 2023 Accepting new patients

Locations

1301 2nd Ave SW
Ste 301
Largo, FL 33770
Phone (727) 544-1441

3830 Tampa Rd
Ste 300
Palm Harbor, FL 34684
Phone (727) 366-3876

2815 W Virginia Ave
Ste A
Tampa, FL 33607
Phone (813) 761-2017

2020 Ashley Oaks Cir
Ste 102
Wesley Chapel, FL 33544
Phone (407) 567-4327

Interoperability endpoints

  • Direct secure messaging: brian.pink.1@9636.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/9636/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1585440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1821626607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 NW 50TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326051067",
            "telephone_number": "717-809-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 N MCMULLEN BOOTH RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612008",
            "telephone_number": "855-834-6911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 Ashley Oaks Cir",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335446410",
            "country_code": "US",
            "telephone_number": "855-834-6911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2815 W Virginia Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076357",
            "country_code": "US",
            "telephone_number": "855-834-6911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINK",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-29",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME162231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.