JIBIN VALIYAVEETTIL SAMUEL (MBBS) – Pediatric Anesthesiology Physician, NPI 1841432291

JIBIN VALIYAVEETTIL SAMUEL (MBBS) is a healthcare provider. based in St petersburg, Florida. specializing in ANESTHESIOLOGY. They hold the professional credentials MBBS. They hold a License No. ME104317 (FL). The NPI Number for JIBIN VALIYAVEETTIL SAMUEL (MBBS) is 1841432291

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
JIBIN VALIYAVEETTIL SAMUEL (MBBS)
NPI
1841432291
Phone
(727) 767-8480
Address
501 6TH AVE S
Enumeration Date
1 April 2009
Last Update Date
18 January 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7277274429
Graduation Year
2003 (23 years ago)
PAC ID
4587789243
Group Practice PAC ID
7113989849
Professional Enrollment ID
I20100917000775
Address ID
FL337014804ST601XXSXXX416
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:17State licenses:1Digital endpointsOther names

3,340 ANESTHESIOLOGY in FL

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Provider Addresses for JIBIN VALIYAVEETTIL SAMUEL (MBBS)

  • Johns Hopkins All Children's Hospital, 501, 6th Avenue South, Roser Park, Saint Petersburg, Pinellas County, Florida, 33701, United States

    ST PETERSBURG, FL 337014634

    Phone: (727) 767-8480

    Fax: (727) 767-8420

    Type: Location

  • 5002, West Homer Avenue, Tampa, Hillsborough County, Florida, 33629, United States

    TAMPA, FL 33629

    Phone: (305) 979-5174

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100917000775IAnesthesiologyFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33701)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7113989849View full group profile
NameSpecialtyState
Nurse PractitionerFL
Pulmonary DiseaseFL
H O S P I T A L I S TFL
H O S P I T A L I S TFL
Pediatric Medicine, Cardiovascular Disease (Cardiology)FL
Cardiovascular Disease (Cardiology)FL
Certified Registered Nurse Anesthetist (Crna)FL
General SurgeryVA
Certified Registered Nurse Anesthetist (Crna)FL
A N E S T H E S I O L O G YLA

Reviews

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Frequently asked questions

Does JIBIN VALIYAVEETTIL SAMUEL (MBBS) have a public NPI I can cite?
Public records show JIBIN VALIYAVEETTIL SAMUEL (MBBS) under NPI 1841432291.
Does the public listing show JIBIN VALIYAVEETTIL SAMUEL (MBBS) as active?
JIBIN VALIYAVEETTIL SAMUEL (MBBS)'s NPI record reflects an active status in NPPES.
What type of care does JIBIN VALIYAVEETTIL SAMUEL (MBBS) provide?
JIBIN VALIYAVEETTIL SAMUEL (MBBS)'s profile centers on Pediatric Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
What city is tied to JIBIN VALIYAVEETTIL SAMUEL (MBBS)?
The directory associates JIBIN VALIYAVEETTIL SAMUEL (MBBS) with St Petersburg, Florida. Check all listed addresses for suites or satellite offices.
Who maintains JIBIN VALIYAVEETTIL SAMUEL (MBBS)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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