MR. THOMAS GLEN HETTICH (PA-C) – Physician Assistant, NPI 1992765747
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
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Provider Addresses for MR. THOMAS GLEN HETTICH (PA-C)
Zemke Avenue, Tampa, Hillsborough County, Florida, 33621, United States
ATTN: SOCCENT CLINIC
TAMPA, FL 336215023
Phone: (813) 827-9213
Fax: (813) 827-1319
Type: Location
3250 Zemke Ave
ATTN: SOCCENT Clinic
Tampa, FL 336215023
Phone: (813) 827-9213
Fax: (813) 827-1319
Type: Location
Diaz Street, Longleaf, Starkey Ranch, Pasco County, Florida, 35655, United States
TRINITY, FL 346552163
Phone: (727) 644-2597
Type: Mailing
21044 FREDERICK RD
GERMANTOWN, MD 208764132
Phone: (240) 238-5432
Type: Location
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: 2025-05-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250508000303 | I | Physician Assistant | DC | TBD |
| I20250528003716 | I | Physician Assistant | MD | TBD |
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.
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 33621)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | VA | |
| Sports Medicine, Family Practice | SC | |
| - | NY | |
| Physician Assistant | MD | |
| Nurse Practitioner | VA | |
| Nurse Practitioner | VA | |
| - | DC | |
| Physician Assistant | NC | |
| Physician Assistant | GA | |
| - | IN |
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