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SAMUEL BAHMAN JALALI M.D.
NPI 1962934810
Internal Medicine in Tampa, FL

Active since March 30, 2017PECOS EnrolledAccepts Medicare Assignment
89.43/100
CMS Quality Rating
12902 USF MAGNOLIA DR, TAMPA, FL 33612(813) 745-7365(813) 449-8618 Get Directions Write a Review

NPPES record last updated: May 9, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 9, 2025, Mar 30, 2017 (2 updates tracked since 2017).

About Samuel Bahman Jalali M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL BAHMAN JALALI M.D. (NPI 1962934810) is an individual internal medicine provider in Tampa, Florida, licensed in Florida (ME143719) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS, maintains a secondary practice location in Tampa, and is a graduate of Florida State University College Of Medicine (2017).

NPPES Registry Identity

NPI1962934810
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameSAMUEL BAHMAN JALALICredential: M.D.
Location Address12902 USF MAGNOLIA DRTampa, FL 33612-9416
Mailing AddressPo Box 198441Atlanta, GA 30384-8441 · (813) 745-7365 · Fax (813) 449-8618
Phone(813) 745-7365
Fax(813) 449-8618
Sole ProprietorNo
Medical School CMSFlorida State University College Of MedicineGraduated 2017
Enumeration DateMarch 30, 2017
Last NPPES UpdateMay 9, 20252 updates tracked since enumeration
NPPES CertifiedMay 9, 2025
✔ NPI 1962934810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME143719
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
12902 USF MAGNOLIA DR, Tampa, FL 33612
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Other Names 1

Other Name (5)Sam Jalali

Secondary Practice Location 1

Location 117 Davis Blvd, Suite 308Tampa, FL 33606-3475 · Phone (813) 259-0661

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samuel Bahman Jalali M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7719301498
PECOS Enrollment IDI20200728002656
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Samuel Jalali reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
Same address
Hematology & Oncology
12902 USF MAGNOLIA DR
Tampa, FL 33612
  • Reassigned Medicare billing, Florida enrollment
  • 992 clinicians in this Medicare group
NPI 1306833595 (813) 745-4673

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
63 services62 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
28 services27 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
14 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33612 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

89.43/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.84
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHAEL MARTIN WACH MD
Surgery
12902 USF MAGNOLIA DR
TAMPA, FL 33612
Hillsborough County (813) 745-2916
ASTI ELIZABETH REGO APRN
Nurse Practitioner
12902 USF MAGNOLIA DR
TAMPA, FL 33612
Hillsborough County (813) 745-7365
MR. NIEMA BRANDON RAZAVIAN MD
Radiology (Radiation Oncology)
12902 USF MAGNOLIA DR
TAMPA, FL 33612
Hillsborough County (137) 457-3658
BRANDON HOLMES
Nurse Anesthetist, Certified Registered
12902 USF MAGNOLIA DR
TAMPA, FL 33612
Hillsborough County (813) 745-4673
FRANCES IVELISSE BERNARDO MERCADO PA-C
Physician Assistant
12902 USF MAGNOLIA DR
TAMPA, FL 33612
Hillsborough County (813) 745-4673
SADHVI BATRA MD
Obstetrics & Gynecology
12902 USF MAGNOLIA DR
TAMPA, FL 33612
Hillsborough County (813) 745-7365
JING WANG M.D.
Pathology (Anatomic Pathology)
12902 USF MAGNOLIA DR
TAMPA, FL 33612
Hillsborough County (813) 745-4673
MR. MARC VINCENT MANACCI CRNA
Anesthesiology
12902 USF MAGNOLIA DR
TAMPA, FL 33612
Hillsborough County (813) 745-4673

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Jalali's NPI number?

The NPI number for Samuel Jalali is 1962934810. It was assigned to this individual provider in the NPPES registry on March 30, 2017. The provider is also known as Sam Jalali.

Where is Samuel Jalali located?

Samuel Jalali practices at 12902 Usf Magnolia Dr, Tampa, FL 33612. The listed phone number is (813) 745-7365.

What is Samuel Jalali's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Samuel Jalali enrolled in Medicare?

Yes. Samuel Jalali is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Samuel Jalali's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Jalali reassigns Medicare benefits to H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc (Tampa, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Jalali's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Samuel Jalali was last updated on May 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.