Individual provider Active NPI

Jeremy White, DO

  • Emergency Medicine Physician
  • Tampa, FL
National Provider Identifier
1912103573
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS11399 Issued in FL
Practice address
3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone
(813) 971-6000
Fax
(813) 972-5753
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OT011974 PA
Emergency Medicine Physician 207P00000X OS11399 FL Primary

Addresses

Primary practice location

3100 E Fletcher Ave
Tampa, FL 33613-4613

Mailing address

12479 Telecom Dr
Temple Terrace, FL 33637-0913
Phone (813) 972-4199

Other identifiers 2

IdentifierTypeStateIssuer
003854800MedicaidFL
14F2GOtherFLBCBS FLORIDA

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
I20110825000311 FL Practitioner - Emergency Medicine 0345410528 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa Bay Emergency Physicians, LLCGroup PAC ID 0345260345, 55 clinicians
Tampa Bay Emergency Physicians-Heartland LLCGroup PAC ID 0749577781, 45 clinicians

Practice addresses (Care Compare)

3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (813) 971-6000

4200 Sun N Lake Blvd
Sebring, FL 33872-1986
Phone (863) 314-4466

Hospital & facility affiliations

  • Adventhealth North Pinellas Hospital, Tarpon Springs, FL, CCN 100055
  • Adventhealth Zephyrhills Hospital, Zephyrhills, FL, CCN 100046

Merit-based Incentive Payment System (MIPS)

Final score
93.12 of 100Reported as group
Quality
83.29
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.65 of 100Reported as group
Quality
90.03
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT011974PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Bay Emergency Physicians-Heartland LLC Emergency Medicine CurrentSince Aug 11, 2016 Accepting new patients
Tampa Bay Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2011 Accepting new patients
Abington Emergency Physician Associates PC Emergency Medicine Past Accepting new patients

Locations

1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

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

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

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

12479 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 972-4199

735 S 5th Ave
Wauchula, FL 33873
Phone (863) 402-3402

4535 Dressler Rd NW
Canton, OH 44718
Phone (330) 994-4409

Organizations & group practices 3

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 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": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1912103573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12479 TELECOM DR",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370913",
            "telephone_number": "813-972-4199",
            "fax_number": "813-972-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134613",
            "telephone_number": "813-971-6000",
            "fax_number": "813-972-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JEREMY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT011974",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS11399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003854800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FLORIDA",
            "identifier": "14F2G",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.