Individual provider Active NPI

Kathia Ruby Fantauzzi Nieves, MD

  • Diagnostic Radiology Physician
  • Tampa, FL
National Provider Identifier
1972065720
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME173563 Issued in FL
Practice address
14055 Riveredge Dr Ste 250
Tampa, FL 33637-2141
Phone
(813) 929-5451
NPI assigned
Apr 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME173563 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

14055 Riveredge Dr Ste 250
Tampa, FL 33637-2141

Mailing address

14055 Riveredge Dr Ste 250
Tampa, FL 33637-2141
Phone (813) 929-5451

Other practice location 1

2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone (516) 296-6785

Other practice location 2

601 Elmwood Ave Box 648
Rochester, NY 14642-0001
Phone (585) 273-5476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 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
I20240515002877 NY Practitioner - Diagnostic Radiology 5890136311 Reassigns benefits to 2 organizations
I20250913000812 FL Practitioner - Diagnostic Radiology 5890136311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260

2600 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9207
Phone (813) 929-5436

2700 Healing Way
Wesley Chapel, FL 33543-5453

7050 Gall Blvd
Zephyrhills, FL 33541-1347
Phone (813) 788-0411

Hospital & facility affiliations

  • Adventhealth Wesley Chapel Hospital, Wesley Chapel, FL, CCN 100319
  • Adventhealth Zephyrhills Hospital, Zephyrhills, FL, CCN 100046
  • AdventHealth Carrollwood Hospital, Tampa, FL, CCN 100069
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Radiologists of Univ of Rochester Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients
Mammography of the University of Rochester Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients
Florida Hospital Physician Group Inc CurrentSince Nov 3, 2025 Accepting new patients

Locations

14055 Riveredge Dr
Ste 250
Tampa, FL 33637
Phone (813) 396-6238

14055 Riveredge Dr
Tampa, FL 33637

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

601 Elmwood Ave
#648
Rochester, NY 14642
Phone (585) 275-1376

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: kfantauzzinieves494278@direct.urmc.rochester.edu

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 5

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1972065720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14055 RIVEREDGE DR STE 250",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336372141",
            "telephone_number": "813-929-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14055 RIVEREDGE DR STE 250",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336372141",
            "telephone_number": "813-929-5451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Hempstead Tpke",
            "address_purpose": "LOCATION",
            "city": "East Meadow",
            "state": "NY",
            "postal_code": "115541859",
            "country_code": "US",
            "telephone_number": "516-296-6785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Elmwood Ave Box 648",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-273-5476",
            "fax_number": "585-273-1033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANTAUZZI NIEVES",
        "first_name": "KATHIA",
        "middle_name": "RUBY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME173563",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.