Lisa M Disanto (NPI# 1457396590, PAC ID# 7416115605) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL PRACTICE.
| Nation Provider ID (NPI) | 1457396590 |
| PAC ID by PECOS | 7416115605 |
| Professional Enrollment ID | I20120220000333 |
| Full Name | Lisa M Disanto |
| Organization Legal Name | DIAGNOSTIC CLINIC MEDICAL GROUP INC |
| Address |
6776 54th Ave N Suite A Saint Petersburg FL 33709-1405 |
| Phone Number | 7275488500 |
| Gender | F |
| Graduation Year | 1986 |
| Primary Specialty | GENERAL PRACTICE |
| Group Practice PAC ID | 4082526280 |
| Number of Group Practice Members | 70 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100127 | MORTON PLANT HOSPITAL |
| 100180 | ST PETERSBURG GENERAL HOSPITAL |
| 100067 | ST ANTHONY'S HOSPITAL |
| 100126 | PALMS OF PASADENA HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 6776 54th Ave N, Suite A, Saint Petersburg, FL 33709-1405 | 7275488500 | DIAGNOSTIC CLINIC MEDICAL GROUP INC |
| Organization Legal Name | DIAGNOSTIC CLINIC MEDICAL GROUP INC |
| Physicians | 95 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Victoria L James | Nurse Practitioner | Diagnostic Clinic Medical Group Inc | 3131 N Mcmullen Booth Rd, Clearwater, FL 33761-2008 |
| Samir Klapuh | Nurse Practitioner | Diagnostic Clinic Medical Group Inc | 630 Pasadena Ave S, St Petersburg, FL 33707-2128 |
| Ron R Hiemstra | Family Practice | Diagnostic Clinic Medical Group Inc | 630 Pasadena S Ave, Saint Petersburg, FL 33707-2128 |
| Maria D Quintela | Occupational Therapy | Diagnostic Clinic Medical Group Inc | 1301 2nd Ave Sw, Largo, FL 33770-3120 |
| Meredith L Dykes | Nurse Practitioner | Diagnostic Clinic Medical Group Inc | 6776 54th Ave N, Suite A, Saint Petersburg, FL 33709-1405 |
| Eva M Yacobi | Family Medicine | Diagnostic Clinic Medical Group Inc | 1301 2nd Ave Sw, Largo, FL 33770-3120 |
| Jill Marie Roehr | General Surgery | Diagnostic Clinic Medical Group Inc | 3131 N Mcmullen Booth Rd, Clearwater, FL 33761-2008 |
| Robert N Shobe | Internal Medicine | Diagnostic Clinic Medical Group Inc | 3131 N Mcmullen Booth Rd, Clearwater, FL 33761-2008 |
| Brahmesh S Sivaprakasapillai | Cardiovascular Disease (cardiology) | Diagnostic Clinic Medical Group Inc | 1301 2nd Ave Sw, Largo, FL 33770-3120 |
| Mladen Nikolic | Nurse Practitioner | Diagnostic Clinic Medical Group Inc | 1301 2nd Ave Sw, Largo, FL 33770-3120 |
| Street Address |
6776 54TH AVE N SUITE A |
| City | SAINT PETERSBURG |
| State | FL |
| Zip | 33709-1405 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Meredith L Dykes | Nurse Practitioner | Diagnostic Clinic Medical Group Inc | 6776 54th Ave N, Suite A, Saint Petersburg, FL 33709-1405 |
| George R Dunkelberger | Family Practice | Diagnostic Clinic Medical Group Inc | 6776 54th Ave N, Suite A, Saint Petersburg, FL 33709-1405 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amber Shakira Tas | Cardiovascular Disease (cardiology) | Bay Area Heart Center Pa | 5398 Park St N, Suite A, St Petersburg, FL 33709-1041 |
| Mohammad Yamani | Internal Medicine | All Care Medical Consultants Pa | 5301 Park St N, St Petersburg, FL 33709-1042 |
| Jennifer Rebecca Chambers | Family Medicine | Baycare Medical Group, Inc. | 5405 Park N St, Saint Petersburg, FL 33709-1044 |
| Eve L Massarsky | Physician Assistant | Baycare Medical Group, Inc. | 5405 Park N St, Saint Petersburg, FL 33709-1044 |
| Shannaz A Kazi | Family Medicine | Baycare Medical Group, Inc. | 5405 Park N St, Saint Petersburg, FL 33709-1044 |
| Julian R Menendez | Podiatry | 5415 Park St N, Saint Petersburg, FL 33709-1087 | |
| Sushilla N Beecum | Internal Medicine | 7000 54th Ave N, St. Petersburg, FL 33709-1304 | |
| Cynthia A Marqueen | Anesthesiology | 6321 54th Ave N, St Petersburg, FL 33709-1703 | |
| Sardha Perera | Interventional Pain Management | Florida Medical Pain Management LLC | 6333 54th Ave N, St Petersburg, FL 33709-1703 |
| Debra D Fontaine | Certified Registered Nurse Anesthetist | Elite Anesthesia of Florida LLC | 6345 54th Ave N, St Petersburg, FL 33709-1703 |
| Find all physicians in zip 33709 | |||
| City | SAINT PETERSBURG |
| Zip Code | 33709 |
| Specialty | GENERAL PRACTICE |
| City + Specialty | SAINT PETERSBURG + GENERAL PRACTICE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.