Individual provider Active NPI

Mason Cole Qualls, MD

  • Psychiatry Physician
  • Tampa, FL
National Provider Identifier
1841751351
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
161537 Issued in FL
Practice address
603 S Boulevard
Tampa, FL 33606-2629
Phone
(813) 995-1775
Fax
(813) 642-4877
NPI assigned
Mar 27, 2019
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 161537 FL Primary

Addresses

Primary practice location

603 S Boulevard
Tampa, FL 33606-2629

Mailing address

603 S Boulevard
Tampa, FL 33606-2629
Phone (813) 995-1775

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
I20230829001034 FL Practitioner - Psychiatry 7810350519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Arkansas College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tampa NeuropsychiatryGroup PAC ID 4385928647, 15 clinicians

Practice addresses (Care Compare)

1118 Bell Shoals Rd
Brandon, FL 33511-8822
Phone (813) 995-1775

4710 N Habana Ave
Suite 203
Tampa, FL 33614-7146
Phone (813) 995-1775

6450 38TH Ave N
200 Tampa Neuropsychiatry and TMS Group
St Petersburg, FL 33710-1649
Phone (727) 440-5513

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
161537FLMDPsychiatry Physician

Networks

  • Freedom Health HMO Network

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1841751351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 S BOULEVARD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062629",
            "telephone_number": "813-995-1775",
            "fax_number": "813-642-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S BOULEVARD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062629",
            "telephone_number": "813-995-1775",
            "fax_number": "813-642-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUALLS",
        "first_name": "MASON",
        "middle_name": "COLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "161537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.