Individual provider Active NPI

Timmi Maxmillian, DO

  • Family Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1902536188
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS22420 Issued in FL
Practice address
6801 4TH St N
St Petersburg, FL 33702-6844
Phone
(727) 822-3238
NPI assigned
Jun 12, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS22420 FL Primary

Addresses

Primary practice location

6801 4TH St N
St Petersburg, FL 33702-6844

Mailing address

12013 Whistling Wind Dr
Riverview, FL 33569-4801
Phone (813) 468-0278

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Timmi.MaxmillianDO@direct.mybaycare.org Health Information Exchange (HIE)

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
I20250903000519 FL Practitioner - Family Practice 4385023373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie Col of Osteopathic Medicine, Bradenton, 2022
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)

6801 4TH St N
St Petersburg, FL 33702-6844
Phone (727) 822-3238

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Sep 15, 2025 Accepting new patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Sep 15, 2025 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

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

6801 4th St N
St Petersburg, FL 33702
Phone (727) 822-3238

Interoperability endpoints

  • Direct secure messaging: tmaxmillian620574@adventhealth.direct-ci.com
  • Direct secure messaging: timmi.maxmilliando@direct.mybaycare.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1654992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1902536188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12013 WHISTLING WIND DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335694801",
            "telephone_number": "813-468-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337026844",
            "telephone_number": "727-822-3238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXMILLIAN",
        "first_name": "TIMMI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-12",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS22420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Timmi.MaxmillianDO@direct.mybaycare.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6801 4TH ST N",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337026844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.