Individual provider Active NPI

Mary Therese Parisi, M.D.

  • Dermatopathology (Pathology) Physician
  • Tampa, FL
National Provider Identifier
1942416334
Registry record updated Oct 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
ME 92639 Issued in FL
Practice address
17909 Bahama Isle Drive
Tampa, FL 33647
Phone
(813) 731-0564
NPI assigned
May 15, 2007
Last updated
Oct 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X ME 92639 FL Primary

Addresses

Primary practice location

17909 Bahama Isle Drive
Tampa, FL 33647

Mailing address

17909 Bahama Isle Drive
Tampa, FL 33647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040707000138 NY Practitioner - DermatologyPractitioner - Pathology 4880671957 Reassigns benefits to 3 organizations
I20260320000456 CT Practitioner - Pathology 4880671957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Hahnemann University College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bodian Dermatology Group PCGroup PAC ID 2062483316, 2 clinicians
Eastern Connecticut Pathology Consultants, PCGroup PAC ID 3173511581, 19 clinicians

Practice addresses (Care Compare)

11 Grace Ave
Suite 100
Great Neck, NY 11021-2417
Phone (516) 482-2882

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 647-6487

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 92639FLMDDermatopathology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Oct 21, 2019 Accepting new patients
Robert L Bruckstein MD PC Current Accepting new patients
Bodian Dermatology Group, P.C CurrentSince May 8, 2021 Accepting new patients
Comprehensive Dermatology, P.C. CurrentSince May 8, 2021 Accepting new patients
Bodian Medical Services of Forest Hills PC PastSince May 8, 2021 Accepting new patients
Eastern Connecticut Pathology Consultants, PC Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

11 Grace Ave
Ste 100
Great Neck, NY 11021
Phone (516) 482-2882

300 Community Dr
Manhasset, NY 11030

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

1991 Marcus Ave
Ste 300
North New Hyde Park, NY 11042
Phone (516) 321-8509

972 Brush Hollow Rd
Westbury, NY 11590

1122 Broadway
Woodmere, NY 11598
Phone (516) 295-3838

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 6

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318636800000",
    "number": "1942416334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17909 BAHAMA ISLE DRIVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17909 BAHAMA ISLE DRIVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33647",
            "telephone_number": "813-731-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARISI",
        "first_name": "MARY",
        "middle_name": "THERESE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2011-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "FL",
            "license": "ME 92639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.