Andrew Niclosi

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME156636 Issued in FL

Practice address

119 Oakfield Dr
Brandon, FL 33511-5779

Phone

(813) 681-5551

Fax

(813) 916-2944

NPI assigned

Mar 19, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

University of Tennessee, HSC, College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allied Im LLCGroup PAC ID 6406074947, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Brandon Hospital Hospital, Brandon, FL, CCN 100243

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrew.niclosi@hca4.eclinicaldirectplus.com

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.

• Allied Im LLC

  • Internal Medicine Physician
  • Brandon, FL
  • NPI 1295140325
  Medicare reassignment Care Compare group NPD
• Advanced Intergrated Medicine Inc

  • Internal Medicine Physician
  • Brandon, FL
  • NPI 1164733861
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Galencare, Inc.

  • General Acute Care Hospital
  • Brandon, FL
  • NPI 1669427258
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1902366735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4324 S CLARK AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336111306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115779",
            "telephone_number": "813-681-5551",
            "fax_number": "813-916-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICLOSI",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME156636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thuy Nguyen
• Nia RX Services LLC
• Davonna Marie Nichols-Brown
• David S Nichols, M.D.
• Dustin Christine Nichols
• Nicole Bilodeau, LLC
• Anthony Nicoletti
• Sukaina Nicophene, MSN, ARNP-C, PMHNP-C
• Enzo Andre Nicosia, DO
• Matthew M Nieber V, D.D.S.

• Internal Medicine Physician in Brandon, FL
• Providers in Brandon, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.