Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1689835357 Individual Practitioner Female Practitioner

Dr. Kalyani Manjul Derasari , MD

Pediatrics • Tampa, FL

Professional Overview & Biography Verified Profile Summary

Dr. Kalyani Derasari, MD is a registered healthcare professional specializing in Pediatrics in Tampa, FL. Practice services are available at 4202 E FOWLER AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4202 E Fowler Ave
Shs-100

Tampa, FL 336209951

Telephone 8139742331
Fax 8139747181
Associated Practice Facility / Clinic
🏢 University Of South Florida Facility NPI 1578601654

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Tampa, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.4 Yrs
State Avg: 22.2 Yrs
Regional Practice Density
239 Specialists

Practicing in Tampa, FL (4160 Statewide)

Telehealth Adoption Rate
1.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-01-04
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License FL ME52057

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
000199700 (FL)
Commercial Insurance / Payer ID Blue Cross Blue Shield
05667 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

30 Associated Practitioners
Dr. Hui Lee , MD

Preventive Medicine - Public Health & General Preventive Medicine

NPI 1033317672

Doctor of Medicine (M.D.)

Dr. Jospeh Puccio , MD

Pediatrics - Adolescent Medicine

NPI 1053353037

Doctor of Medicine (M.D.)

Dr. Teresa Dowdy , MD

Internal Medicine

NPI 1104088053

Doctor of Medicine (M.D.)

Katie Webster , RD

Dietitian, Registered

NPI 1114250545

Registered Dietitian

James Steele , ARNP

Nurse Practitioner

NPI 1174566822

Advanced Registered Nurse Practitioner

Emily Gardyasz , LAT, ATC

Specialist/Technologist - Athletic Trainer

NPI 1184107393

Licensed Athletic Trainer, Certified Athletic Trainer

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 04, 2024

Pediatrics (License #ME52057 in FL)

📍
Updated Business Mailing Address October 29, 2020

Registered at PO BOX 917770, ORLANDO, FL 328910001 (Tel: 8139742201)

NPI Profile Active June 08, 2009

NPI status registered as active in NPPES database

📍
Updated Practice Location June 08, 2009

Registered at 4202 E FOWLER AVE, SHS-100, TAMPA, FL 336209951 (Tel: 8139742331)

📍
Updated Business Mailing Address June 08, 2009

Registered at 4202 E FOWLER AVE, SHS-100, TAMPA, FL 336209951 (Tel: 8139742331)

👤
Provider Name / Credentials Updated June 08, 2009

Recorded as KALYANI DERASARI, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 08, 2009

Pediatrics (License #ME52057 in FL)

🟢
Initial NPI Registration & Enumeration June 24, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1689835357
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 24, 2008
Last Update: January 04, 2024
Sole Proprietor: No

Mailing Address

Po Box 917770

Orlando, FL 328910001

Phone: 8139742201

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.