Active NPI
Carissa Simone, M.D.
- Hospitalist Physician
- Tampa, FL
National Provider Identifier
1952763336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- ME139925
- Practice address
- 17 Davis Blvd
Suite 308
Tampa, FL 33606-3475 - Phone
- (813) 250-2506
- NPI assigned
- Mar 24, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME139925 | FL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Hospitalist Physician | 208M00000X | ME139925 | FL | Primary |
Addresses
Primary practice location
17 Davis Blvd
Suite 308
Tampa, FL 33606-3475
Mailing address
17 Davis Blvd
Suite 308
Tampa, FL 33606-3475
Phone (813) 250-2506
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9FMVO | Other | FL | BLUE CROSS BLUE SHIELD |
| 103273200 | Medicaid | FL | |
| LH661 | Other | FL | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME139925 | FL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563321600000",
"number": "1952763336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 DAVIS BLVD",
"address_2": "SUITE 308",
"city": "TAMPA",
"state": "FL",
"postal_code": "336063475",
"telephone_number": "813-250-2506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 DAVIS BLVD",
"address_2": "SUITE 308",
"city": "TAMPA",
"state": "FL",
"postal_code": "336063475",
"telephone_number": "813-250-2506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMONE",
"first_name": "CARISSA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-24",
"last_updated": "2019-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME139925",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "FL",
"license": "ME139925",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "9FMVO",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103273200",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "LH661",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.