| NPI | 1073075222 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2019-04-04 |
| Last Updated | 2025-03-10 |
| Mailing Address | 15815 Shaddock Dr Ste 130 Winter Garden, FL 34787-5773 United States Phone: (813) 400-1140 | Fax: (813) 701-9132 📍 View Map |
| Primary Practice Address | 4700 N Habana Ave Ste 400 Tampa, FL 33614-7119 United States Phone: (813) 499-0774 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | FL | 114530400 | - |
| Other (non-Medicare) | - | 15659126 | CAQH ID |
| Other (non-Medicare) | FL | 6605657 | Aetna |
| Other (non-Medicare) | FL | 7333506 | Cigna ID |
| Other (non-Medicare) | FL | OPOAV | BCBS |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 213EP1101X – Podiatrist, Primary Podiatric Medicine | FL | PO4422 |
| No | 213ES0000X – Podiatrist, Sports Medicine | FL | PO4422 |
| No | 213ES0103X – Podiatrist, Foot & Ankle Surgery | FL | PO4422 |
| No | 213ES0131X – | FL | PO4422 |
| Yes | 213E00000X – Podiatrist | FL | PO4422 |
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About NPI 1073075222
Patrick Derby DPM is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1073075222. The primary specialty listed is Podiatrist. The provider is located in Tampa, FL. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2019-04-04. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1073075222?
NPI 1073075222 belongs to Patrick Derby DPM, a Podiatrist in Tampa, FL. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1073075222 active?
The current status of NPI 1073075222 in the NPPES registry is Active. The record was last updated on 2025-03-10.
What specialty is NPI 1073075222?
NPI 1073075222 is classified under the taxonomy Podiatrist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1073075222?
You can verify NPI 1073075222 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1073075222?
The primary practice address on file for NPI 1073075222 is 4700 N Habana Ave Ste 400, Tampa, FL 33614-7119. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1073075222 issued?
NPI 1073075222 was first issued (enumerated) on 2019-04-04. The NPPES record was last updated on 2025-03-10.
Practice Location Map
Patrick Derby is located at 4700 N Habana Ave Ste 400, Tampa, FL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Patrick Derby. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1073075222. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Podiatrist, Primary Podiatric Medicine | PO4422 | FL |
| Podiatrist, Sports Medicine | PO4422 | FL |
| Podiatrist, Foot & Ankle Surgery | PO4422 | FL |
| 213ES0131X | PO4422 | FL |
| Podiatrist | PO4422 | FL |