Individual provider Active NPI

Brenton Daniel McCoy, D.O.

  • Internal Medicine Physician
  • Largo, FL
National Provider Identifier
1053746479
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS13291 Issued in FL
Practice address
13644 Walsingham Rd
Largo, FL 33774-3532
Phone
(727) 595-2519
Fax
(727) 595-3872
NPI assigned
Sep 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X OS13291 FL
Internal Medicine Physician 207R00000X OS13291 FL Primary

Addresses

Primary practice location

13644 Walsingham Rd
Largo, FL 33774-3532

Mailing address

13644 Walsingham Rd
Largo, FL 33774-3532
Phone (727) 595-2519

Other identifiers 1

IdentifierTypeStateIssuer
015082200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150805006846 FL Practitioner - Internal MedicinePractitioner - Hospitalist 2567776586 Reassigns benefits to 2 organizations
Practice locations: Largo, FL

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc Internal Medicine CurrentSince Jun 5, 2020 Accepting new patients
Suncoast Internal Medicine Consultants, P.a. Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients
Adventist Health System-Sunbelt Inc Internal Medicine Past Accepting new patients

Locations

13644 Washington Rd
Largo, FL 33774
Phone (727) 595-2519

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

12470 Telecom Dr
Ste 100
Temple Terrace, FL 33637
Phone (813) 929-5454

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1053746479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13644 WALSINGHAM RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337743532",
            "telephone_number": "727-595-2519",
            "fax_number": "727-595-3872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13644 WALSINGHAM RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337743532",
            "telephone_number": "727-595-2519",
            "fax_number": "727-595-3872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "BRENTON",
        "middle_name": "DANIEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-04",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS13291",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS13291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015082200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.