| Bluestone | |
|
10150 Highland Manor Dr Ste 205 Tampa FL 33610-9727 | |
| (813) 259-1013 | |
| (813) 254-0396 |
| Full Name | Bluestone |
|---|---|
| Speciality | Family Medicine |
| Location | 10150 Highland Manor Dr Ste 205, Tampa, Florida |
| Authorized Official Name and Position | Diana Bernard (OFFICE MANAGER) |
| Authorized Official Contact | 8132591013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluestone 10150 Highland Manor Dr Ste 205 Tampa FL 33610-9727 Ph: (813) 259-1013 | Bluestone 10150 Highland Manor Dr Ste 205 Tampa FL 33610-9727 Ph: (813) 259-1013 |
| NPI Number | 1346212370 |
|---|---|
| Provider Enumeration Date | 02/03/2006 |
| Last Update Date | 04/30/2026 |
| Certification Date | 04/30/2026 |
| Medicare PECOS PAC ID | 9739086257 |
|---|---|
| Medicare Enrollment ID | O20031215000108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346212370 | NPI | - | NPPES |
| 015006200 | Medicaid | FL | |
| 34388 | Other | FL | BC/BS |
| CK5239 | Other | FL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | William R Harper |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114911427 PECOS PAC ID: 4385784552 Enrollment ID: I20091218000295 |
| Provider Name | Audra E Leedy |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811271760 PECOS PAC ID: 3678729837 Enrollment ID: I20120803000714 |
| Provider Name | Teresa L Passalacqua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679915854 PECOS PAC ID: 1254575426 Enrollment ID: I20130910000825 |
| Provider Name | Megan a Flynn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720020605 PECOS PAC ID: 8921043548 Enrollment ID: I20140115000981 |
| Provider Name | Michael Sussman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1861820599 PECOS PAC ID: 2769612514 Enrollment ID: I20140224000913 |
| Provider Name | Amber Casellas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376900621 PECOS PAC ID: 7012212244 Enrollment ID: I20160225000600 |
| Provider Name | Meagan Ann Ducharme |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881068310 PECOS PAC ID: 8921302183 Enrollment ID: I20160323001349 |
| Provider Name | Kandi Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881133940 PECOS PAC ID: 5496023558 Enrollment ID: I20170613001914 |
| Provider Name | Ramon Osorio Figueroa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376735654 PECOS PAC ID: 0042490815 Enrollment ID: I20170707002219 |
| Provider Name | Paula J Earp |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265499768 PECOS PAC ID: 9335295468 Enrollment ID: I20190404000297 |
| Provider Name | Sebastian Hayatyfar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255891313 PECOS PAC ID: 7416282280 Enrollment ID: I20190716002683 |
| Provider Name | Carly May Jones |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710513569 PECOS PAC ID: 5395169296 Enrollment ID: I20200724001796 |
| Provider Name | Kristen Coles Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396239224 PECOS PAC ID: 8022354935 Enrollment ID: I20210707001849 |
| Provider Name | Preston J Hatlestad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851567192 PECOS PAC ID: 3072668748 Enrollment ID: I20220317001515 |
| Provider Name | Sara Udani |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003059312 PECOS PAC ID: 1153470497 Enrollment ID: I20220406002976 |
| Provider Name | Leoncio Yang Laroco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720682107 PECOS PAC ID: 3971901273 Enrollment ID: I20220819001954 |
| Provider Name | Hunter M Ortiz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1780308593 PECOS PAC ID: 5092191841 Enrollment ID: I20220930001519 |
| Provider Name | Marissa Rose Ortiz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760102453 PECOS PAC ID: 6103202940 Enrollment ID: I20221003001880 |
| Provider Name | Simone Taijae Person Fort |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134854813 PECOS PAC ID: 2264809342 Enrollment ID: I20221102000900 |
| Provider Name | Lacie Jeanne Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497463947 PECOS PAC ID: 5597136648 Enrollment ID: I20230127000855 |
| Provider Name | Elsa Lawrence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992319529 PECOS PAC ID: 5698183184 Enrollment ID: I20230822002446 |
| Provider Name | Amber Nicoal Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316417892 PECOS PAC ID: 1355764754 Enrollment ID: I20230920003968 |
| Provider Name | Victoria T Hine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952183030 PECOS PAC ID: 0446602353 Enrollment ID: I20240116004059 |
| Provider Name | Ashley Castro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114798881 PECOS PAC ID: 3173967924 Enrollment ID: I20240220002257 |
| Provider Name | Jennifer Marie Greggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518722719 PECOS PAC ID: 4688110463 Enrollment ID: I20240729003267 |
| Provider Name | Jimi Williamceau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902631948 PECOS PAC ID: 5890222970 Enrollment ID: I20241231003517 |
| Provider Name | Mary P Markovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073319612 PECOS PAC ID: 3072034156 Enrollment ID: I20250305001890 |
Main St Medical USA Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11734 North Dale Mabry, Tampa, FL 33618 Phone: 813-968-6000 Fax: 813-968-6007 |
Infante Medical Office Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4712 N Armenia Ave, Suite 102, Tampa, FL 33603 Phone: 813-873-1725 Fax: 813-873-2924 |
After Care Centers of Florida LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3424 W Kennedy Blvd, Tampa, FL 33609 Phone: 855-716-3342 |
Eugene a Ward M.D. PA Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3450 E Fletcher Avenue, Suite 310, Tampa, FL 33613 Phone: 813-972-1654 Fax: 813-972-7176 |
Sarroca Medical Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3709 W Hamilton Ave, Unit 9., Tampa, FL 33614 Phone: 813-374-7608 Fax: 813-374-9124 |
Simmons Medical Group South Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Harbour Place Dr Unit 2007, Tampa, FL 33602 Phone: 248-321-6612 Fax: 813-964-6337 |