Individual provider Active NPI

Fernando Perez IV, DO

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1861079576
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS20707 Issued in FL
Practice address
203 N Marion St FL 2
Tampa, FL 33602-4914
Phone
(813) 474-9804
Fax
(813) 540-6025
NPI assigned
Mar 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X OS20707 FL Primary

Addresses

Primary practice location

203 N Marion St FL 2
Tampa, FL 33602-4914

Mailing address

6000 49TH St N
St Petersburg, FL 33709-2114

Other practice location 1

6000 49th St N
St Petersburg, FL 33709-2114
Phone (727) 521-5057

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
I20240612001368 FL Practitioner - Internal MedicinePractitioner - Hospitalist 5698217164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Nova Southeastern College of Osteo Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Specialists GroupGroup PAC ID 0345584835, 66 clinicians

Practice addresses (Care Compare)

203 N Marion St
FL 2
Tampa, FL 33602-4914
Phone (813) 428-6904

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Specialists Group Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients
Inpatient Specialists Group Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients

Locations

203 N Marion St
Fl 2
Tampa, FL 33602
Phone (813) 428-6904

602 S Audubon Ave
Ste A
Tampa, FL 33609
Phone (813) 540-4322

203 N Marion St
Tampa, FL 33602
Phone (813) 474-9804

Organizations & group practices 2

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 3

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": "1616803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1861079576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 49TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N MARION ST FL 2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024914",
            "telephone_number": "813-474-9804",
            "fax_number": "813-540-6025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6000 49th St N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337092114",
            "country_code": "US",
            "telephone_number": "727-521-5057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "FERNANDO",
        "name_suffix": "IV",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-27",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS20707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.