Individual provider Active NPI

Barbara Pacholec, M.D.

  • Internal Medicine Physician
  • Lutz, FL
National Provider Identifier
1073696902
Registry record updated Jul 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME79196 Issued in FL
Practice address
24622 State Road 54
Lutz, FL 33559-7307
Phone
(813) 909-4430
Fax
(813) 949-2684
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME79196 FL Primary

Addresses

Primary practice location

24622 State Road 54
Lutz, FL 33559-7307

Mailing address

24622 State Road 54
Lutz, FL 33559-7307

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
I20160209002519 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4284938416

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME79196FLMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185753600000",
    "number": "1073696902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24622 STATE ROAD 54",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335597307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24622 STATE ROAD 54",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335597307",
            "telephone_number": "813-909-4430",
            "fax_number": "813-949-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHOLEC",
        "first_name": "BARBARA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME79196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.