Individual provider Active NPI

Kent Richardson Corral, M.D.

  • Legal Medicine
  • Tampa, FL
National Provider Identifier
1841263209
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
ME0035361 Issued in FL
Practice address
4700 N Habana Ave
Suite 103
Tampa, FL 33614-7160
Phone
(813) 348-0224
Fax
(813) 872-6792
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X ME0035361 FL Primary

Addresses

Primary practice location

4700 N Habana Ave
Suite 103
Tampa, FL 33614-7160

Mailing address

803 W Lowry LN
Tampa, FL 33604-4711
Phone (813) 348-0224

Other identifiers 2

IdentifierTypeStateIssuer
219133OtherFLAVMED
30392OtherFLBCBS

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
I20041109000641 FL Practitioner - Internal Medicine 7810968955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Florida College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sports and Orthopedic Rehabilitation Services IncGroup PAC ID 0840104253, shared by 4 NPIs, 314 clinicians

Practice addresses (Care Compare)

3411 S Dale Mabry Hwy
Tampa, FL 33629-8658
Phone (813) 742-9501

4700 N Habana Ave
Suite 103
Tampa, FL 33614-7160

4700 N Habana Ave
Suite 700
Tampa, FL 33614-7122
Phone (813) 348-0224

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.69 of 100Reported as individual
Quality
99.38
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0035361FLMDLegal Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kent R Corral MD PL CurrentSince Jan 1, 2002 Accepting new patients

Locations

4700 N Habana Ave
Ste 103
Tampa, FL 33614
Phone (813) 348-0224

4700 N Habana Ave
Ste 700
Tampa, FL 33614
Phone (813) 348-0224

Interoperability endpoints

  • Direct secure messaging: kentcorral@krc.ssdirect.aprima.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1841263209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 W LOWRY LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336044711",
            "telephone_number": "813-348-0224",
            "fax_number": "813-872-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N HABANA AVE",
            "address_2": "SUITE 103",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147160",
            "telephone_number": "813-348-0224",
            "fax_number": "813-872-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRAL",
        "first_name": "KENT",
        "middle_name": "RICHARDSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "FL",
            "license": "ME0035361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "219133",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30392",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.