Individual provider Active NPI

Devin Alexandra Gapstur, D.M.D.

  • Dentist
  • St Petersburg, FL
National Provider Identifier
1902167760
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN19729 Issued in FL
Practice address
5427 Bayou Grande Blvd NE
St Petersburg, FL 33703-1811
Phone
(772) 631-5717
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN19729 FL Primary

Addresses

Primary practice location

5427 Bayou Grande Blvd NE
St Petersburg, FL 33703-1811

Mailing address

5427 Bayou Grande Blvd NE
St Petersburg, FL 33703-1811
Phone (772) 631-5717

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150724011190 CA Order and Referring Only - DentistPractitioner - Dentist 3779896394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN19729FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Devin Gapstur, D.M.D. PA Current Accepting new patients
Devin Gapstur, D.M.D. PA Current Accepting new patients

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, 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": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1902167760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5427 BAYOU GRANDE BLVD NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337031811",
            "telephone_number": "772-631-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5427 BAYOU GRANDE BLVD NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337031811",
            "telephone_number": "772-631-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAPSTUR",
        "first_name": "DEVIN",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.