Individual provider Active NPI

Lance Kreplick, MD

  • Emergency Medicine Physician
  • Riverview, FL
National Provider Identifier
1083661441
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME72056 Issued in FL
Practice address
11339 Hawks Fern Dr
Riverview, FL 33569-5714
Phone
(813) 361-1096
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME72056 FL Primary

Addresses

Primary practice location

11339 Hawks Fern Dr
Riverview, FL 33569-5714

Mailing address

11339 Hawks Fern Dr
Riverview, FL 33569-5714
Phone (813) 361-1096

Other identifiers 2

IdentifierTypeStateIssuer
251254800MedicaidFL
21010OtherFLBCBS FL

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
I20041021000261 FL Practitioner - Emergency Medicine 4789645987

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME72056FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC Current Accepting new patients
Capri Emergency Physicians Emergency Medicine Past Accepting new patients
Palm Harbor Emergency Physicians Emergency Medicine Past Accepting new patients
West Florida Trauma Network, LLC Past Accepting new patients

Locations

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1083661441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11339 HAWKS FERN DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695714",
            "telephone_number": "813-361-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11339 HAWKS FERN DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695714",
            "telephone_number": "813-361-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREPLICK",
        "first_name": "LANCE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME72056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251254800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "21010",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.