Individual provider Active NPI

Samuel Tarantino Jr., M.D.

  • Reproductive Endocrinology Physician
  • Tampa, FL
National Provider Identifier
1972598001
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
ME60187 Issued in FL
Practice address
5245 E Fletcher Ave
Suite 1
Tampa, FL 33617-1126
Phone
(813) 914-7304
Fax
(813) 676-8812
NPI assigned
Sep 14, 2005
Last updated
Apr 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X ME60187 FL Primary

Addresses

Primary practice location

5245 E Fletcher Ave
Suite 1
Tampa, FL 33617-1126

Mailing address

5245 E Fletcher Ave
Suite 1
Tampa, FL 33617-1126
Phone (813) 914-7304

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
I20110908002082 FL Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 0840273546

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME60187FLMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RMG Art Laboratory Past Accepting new patients
RMG Ivf/ Surgery Center LLC Past Accepting new patients

Organizations & group practices 2

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1972598001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5245 E FLETCHER AVE",
            "address_2": "SUITE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336171126",
            "telephone_number": "813-914-7304",
            "fax_number": "813-676-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5245 E FLETCHER AVE",
            "address_2": "SUITE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336171126",
            "telephone_number": "813-914-7304",
            "fax_number": "813-676-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARANTINO",
        "first_name": "SAMUEL",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "FL",
            "license": "ME60187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.