NPIMap

Organization Active NPI

Baycare Medical Group Inc

  • Ophthalmology Physician
  • St Petersburg, FL
National Provider Identifier
1093385452
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
BAYCARE MEDICAL GROUP INC
Practice address
620 10TH St N Ste 2C
St Petersburg, FL 33705-1407
Phone
(727) 824-7134
Fax
(727) 724-8329
NPI assigned
Jun 29, 2021
Last updated
Jun 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Authorized official

Name
Lynda Gorken
Title
VP, PFS
Phone
(727) 281-9202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

620 10TH St N Ste 2C
St Petersburg, FL 33705-1407

Mailing address

2995 Drew St FL 3
Clearwater, FL 33759-3012

Other names 1

  • Suncoast Medical Clinic Ophthalmology Other name

National Provider Directory

National Provider Directory
Tax ID family
MPPC Eastlake Internal202 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1093385452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 3",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 10TH ST N STE 2C",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051407",
            "telephone_number": "727-824-7134",
            "fax_number": "727-724-8329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYCARE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "GORKEN",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "VP, PFS",
        "authorized_official_telephone_number": "727-281-9202"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suncoast Medical Clinic Ophthalmology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.