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NPI 1043743354ActiveIndividual· Pediatrics, Pediatric Hematology-Oncology· St Petersburg, FL
Pediatrics, Pediatric Hematology-Oncology in St Petersburg, Florida, trained at University of Missouri, Kansas City, School of Medicine (class of 2017). Enrolled in Medicare as practitioner - hematology/oncology.
Overview
| NPI | 1043743354 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Apr 5, 2017 |
| Last updated in NPPES | Jul 24, 2024 |
| Certified by provider | Jul 24, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics, Pediatric Hematology-Oncology Primary | 2080P0207X | ME160714 | FL |
| Pediatrics | 208000000X | 84979 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Hematology/Oncology (FL) |
|---|
Education and affiliations
| Medical school | University of Missouri, Kansas City, School of Medicine |
|---|---|
| Graduation year | 2017 |
| Medicare specialty | Hematology/Oncology |
| Secondary specialties | Pediatric Medicine |
Medical group
- Pediatric Physician Services, Inc.St Petersburg, FL · 209 clinicians
Hospital affiliation
- Johns Hopkins All Children's HospitalSaint Petersburg, FL
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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