Individual provider Active NPI

Sanaz Maegan Rykwalder, DO

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1972166346
Registry record updated Mar 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS19959 Issued in FL
Practice address
2555 E Hanna Ave Ste 106
Tampa, FL 33610-1365
Phone
(813) 550-0634
Fax
(888) 571-1452
NPI assigned
Apr 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2024

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 OS19959 FL Primary

Addresses

Primary practice location

2555 E Hanna Ave Ste 106
Tampa, FL 33610-1365

Mailing address

15017 N Dale Mabry Hwy # 1277
Tampa, FL 33618-1816
Phone (909) 576-8404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS19959FLMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711843200000",
    "number": "1972166346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15017 N DALE MABRY HWY # 1277",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336181816",
            "telephone_number": "909-576-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 E HANNA AVE STE 106",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336101365",
            "telephone_number": "813-550-0634",
            "fax_number": "888-571-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYKWALDER",
        "first_name": "SANAZ",
        "middle_name": "MAEGAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-20",
        "last_updated": "2024-03-31",
        "certification_date": "2024-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS19959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.