Individual provider Active NPI

Jason D Philippe, MD

  • Family Medicine Physician
  • Saint Petersburg, FL
National Provider Identifier
1982165775
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME149618 Issued in FL
Practice address
6450 38TH Ave N Ste 300
Saint Petersburg, FL 33710-1649
Phone
(727) 655-9850
Fax
(276) 559-8517
NPI assigned
Mar 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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 ME149618 FL Primary

Addresses

Primary practice location

6450 38TH Ave N Ste 300
Saint Petersburg, FL 33710-1649

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

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
I20220127002257 FL Practitioner - Family Practice 4284068578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Coast Primary Care LLCGroup PAC ID 6709041585, 4 clinicians

Practice addresses (Care Compare)

12450 Roosevelt Blvd N
Suite 101
St Petersburg, FL 33716-1902
Phone (727) 571-1688

Hospital & facility affiliations

  • Prohealth Home Health Services Inc Home health agency, Saint Petersburg, FL, CCN 683166
  • Orlando Health Bayfront Hospital Hospital, Saint Petersburg, FL, CCN 100032
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • St Anthonys Hospital Hospital, Saint Petersburg, FL, CCN 100067
  • HCA Florida Pasadena Hospital a Part of HCA Florid Hospital, Saint Petersburg, FL, CCN 100126

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME149618FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Primary Care, LLC Family Medicine CurrentSince Apr 1, 2023 Accepting new patients
SC Physicians LLC PastSince Apr 1, 2023 Accepting new patients

Locations

12450 Roosevelt Blvd N
Ste 101
St Petersburg, FL 33716
Phone (727) 571-1688

601 7th St S
St Petersburg, FL 33701
Phone (727) 572-0900

603 7th St S
Ste 520
St Petersburg, FL 33701
Phone (727) 893-6500

Networks

  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jason.philippe@direct.mybaycare.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/HIGJBA

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 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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1982165775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 38TH AVE N STE 300",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337101649",
            "telephone_number": "727-655-9850",
            "fax_number": "276-559-8517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIPPE",
        "first_name": "JASON",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME149618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

Verify at the official NPI Registry.