Meira Marna Pernicone, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME58939 Issued in FL

Practice address

17416 Brookside Trace CT.
Tampa, FL 33647

Phone

(813) 974-5275

Fax

(813) 908-8835

NPI assigned

Mar 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mary M. Pernicone Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Tampa General Medical Group Inc

  • Surgery Physician
  • Tampa, FL
  • NPI 1043557853
  Medicare reassignment NPD
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• Tampa General Medical Group Inc

  • Cardiovascular Disease Physician
  • Sun City Center, FL
  • NPI 1144910316
  NPD
• Tampa General Medical Group Inc

  • Medical Oncology Physician
  • Tampa, FL
  • NPI 1821626383
  NPD
• University Medical Service Association Inc

  • Neurological Surgery Physician
  • Tampa, FL
  • NPI 1740227966
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1992824122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5922 TARAWOOD DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328194420",
            "telephone_number": "407-620-9596",
            "fax_number": "813-905-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17416 BROOKSIDE TRACE CT.",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33647",
            "telephone_number": "813-974-5275",
            "fax_number": "813-908-8835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 E Fletcher Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336134808",
            "country_code": "US",
            "telephone_number": "813-974-5275",
            "fax_number": "813-905-8835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERNICONE",
        "first_name": "MEIRA",
        "middle_name": "MARNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME58939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "14FX3",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003930900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpernicone92097@direct.tgh.org",
            "affiliation": "N",
            "address_1": "17416 Brookside Trace Ct.",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "PERNICONE",
            "middle_name": "M.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathleen Cunningham Permenter, PA-C
• Fabiana Perna, MD PHD
• Timothy Francis Perna
• Augusto Mikhail Pernia, L.M.T
• Charles Vincent Perniciaro, M.D.
• Charity Jane Pero, COTA/L
• Julliette Anne Peron, ARNP
• Gerard A Perret Jr., DDS
• Abigail Perri, DC
• Karen J Perrin, ARNP

• Surgery Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.