Individual provider Active NPI

Tristan Marcus

  • Clinical Social Worker
  • St Petersburg, FL
National Provider Identifier
1881188340
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
7901 4TH St N Ste 300
Saint Petersburg, FL 33702-4399
Phone
(407) 607-2876
NPI assigned
Jun 19, 2018
Last updated
Oct 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

7901 4TH St N Ste 300
Saint Petersburg, FL 33702-4399

Mailing address

7901 4TH St N Ste 300
Saint Petersburg, FL 33702-4399
Phone (407) 607-2876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Grove Wellness Center, LLC Clinical Current Accepting new patients

Locations

7901 4th St N
Ste 300
St Petersburg, FL 33702
Phone (305) 204-3616

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": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1881188340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N STE 300",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337024399",
            "telephone_number": "407-607-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N STE 300",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337024399",
            "telephone_number": "407-607-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "TRISTAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.