Individual provider Active NPI

Glenn Syperda, DO

  • Pain Medicine (Anesthesiology) Physician
  • Tampa, FL
National Provider Identifier
1891888756
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
OS4956 Issued in FL
Practice address
7171 N Dale Mabry Hwy
Tampa, FL 33614-2630
Phone
(352) 867-8898
Fax
(352) 732-6282
NPI assigned
Oct 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X OS4956 FL Primary

Addresses

Primary practice location

7171 N Dale Mabry Hwy
Tampa, FL 33614-2630

Mailing address

PO Box 862810
Orlando, FL 32886-2810
Phone (352) 867-8898

Other identifiers 2

IdentifierTypeStateIssuer
82788OtherFLBLUE CROSS BLUE SHIELD
271835900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041214001077 FL Practitioner - Anesthesiology 4486545548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Midwestern University, Chicago College of Osteopathic Med, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Witmer Rd
Suite 220
Horsham, PA 19044-2279

18167 US Hwy 19 N
Suite 650
Clearwater, FL 33764-3528

Perioperative Services LLC 111 Continental Dr
Suite 412
Newark, DE 19713-4332

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Pinellas Anesthesia Associates, PA Pain Medicine CurrentSince Oct 1, 1987 Accepting new patients
Florida Gulf-to-Bay Anesthesiology Associates, LLC Pain Medicine Past Accepting new patients
Appalachian Regional Healthcare, Inc. Past Accepting new patients
Providence Physician Group Inc Past Accepting new patients

Locations

3291 N McMullen Booth Rd
Clearwater, FL 33761
Phone (727) 725-5800

7171 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 558-8001

1395 S Pinellas Ave
Tarpon Springs, FL 34689
Phone (727) 942-5000

Organizations & group practices 4

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 1

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891888756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 862810",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328862810",
            "telephone_number": "352-867-8898",
            "fax_number": "352-732-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7171 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142630",
            "telephone_number": "352-867-8898",
            "fax_number": "352-732-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYPERDA",
        "first_name": "GLENN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "OS4956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "82788",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271835900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.