Organization Active NPI

Advanced Care Gastroenterology Associates

  • Gastroenterology Physician
  • Tampa, FL
National Provider Identifier
1831565688
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME106694 Issued in FL
Legal business name
ADVANCED CARE GASTROENTEROLOGY ASSOCIATES
Practice address
15303 Amberly Dr Ste a
Tampa, FL 33647-2308
Phone
(813) 751-9727
Fax
(813) 441-7373
NPI assigned
Aug 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Authorized official

Name
Sobia Ali, MDNPI 1417166422
Title
Doctor
Phone
(847) 525-0020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X ME106694 FL Primary

Addresses

Primary practice location

15303 Amberly Dr Ste a
Tampa, FL 33647-2308

Mailing address

15303 Amberly Dr Ste a
Tampa, FL 33647-2308
Phone (813) 751-9727

Other identifiers 1

IdentifierTypeStateIssuer
1417166422OtherFLINDIVIDUAL NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151208001655 FL Part B Supplier - Clinic/Group Practice 2062712433 Receives reassigned benefits from 13 practitioners
Practice locations: Tampa, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2167623Advanced Care Gastroenterology Associates LLC15303 Amberly Drive Suite a, Tampa, FL 33647ComplianceJul 31, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1831565688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15303 AMBERLY DR STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472308",
            "telephone_number": "813-751-9727",
            "fax_number": "813-441-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15303 AMBERLY DR STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472308",
            "telephone_number": "813-751-9727",
            "fax_number": "813-441-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CARE GASTROENTEROLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-17",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "SOBIA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "847-525-0020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME106694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1417166422",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.