Individual provider Active NPI

Johnathan B John, M.D.

  • Pediatric Cardiology Physician
  • Tampa, FL
National Provider Identifier
1891732814
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
77755 Issued in FL
Practice address
3003 W Dr MLK Blvd
3Rd Floor Mab
Tampa, FL 33607-6307
Phone
(727) 322-4830
Fax
(813) 870-0100
NPI assigned
May 31, 2006
Last updated
Jun 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 77755 FL Primary

Addresses

Primary practice location

3003 W Dr MLK Blvd
3Rd Floor Mab
Tampa, FL 33607-6307

Mailing address

1300 Sawgrass Corporate Pkwy
Suite 200
Sunrise, FL 33323-2826
Phone (727) 322-4830

Other identifiers 1

IdentifierTypeStateIssuer
270521400MedicaidFL

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
I20040915000832 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 3476520750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone (813) 321-6589

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77755FLMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Current Accepting new patients
Tampa General Hospital Current Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Baycare Medical Group, Inc CurrentSince Jan 9, 2025 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Jan 9, 2025 Accepting new patients
Asante-Korang Edwards Giroud Martinez McCormack & Suh MD PA Pediatric Cardiology Past Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

560 Jackson St N
Ste 140
St Petersburg, FL 33705
Phone (727) 322-4830

3001 W Mlk Blvd
Tampa, FL 33607
Phone (813) 361-6778

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: jjohn189202@orlandohealth.medalliesdirect.net
  • Direct secure messaging: jjohn733033@direct.hopkinsmedicine.org
  • Direct secure messaging: jjohn8247@direct.tgh.org

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1891732814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SAWGRASS CORPORATE PKWY",
            "address_2": "SUITE 200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232826",
            "telephone_number": "727-322-4830",
            "fax_number": "813-870-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 W DR MLK BLVD",
            "address_2": "3RD FLOOR MAB",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076307",
            "telephone_number": "727-322-4830",
            "fax_number": "813-870-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "JOHNATHAN",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "77755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270521400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.