Active NPI
Urologic Integrated Care LLC
- Urology Physician
- Gainesville, FL
National Provider Identifier
1104392232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- UROLOGIC INTEGRATED CARE LLC
- Practice address
- 1201 NW 64TH Ter
Gainesville, FL 32605-4220 - Phone
- (352) 204-5400
- Fax
- (352) 204-5405
- NPI assigned
- Oct 16, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Victoria Y Bird, MD
- Title
- Medical Director
- Phone
- (352) 278-5132
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
1201 NW 64TH Ter
Gainesville, FL 32605-4220
Mailing address
5745 SW 75TH St # 507
Gainesville, FL 32608-5504
Phone (352) 204-5400
Other names 1
- Urologic Integrated Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2160125 | Urologic Integrated Care LLC Dba | Certificate of waiver | Jan 3, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Urology Physician
- Gainesville, FL
- NPI 1093856874
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539648000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1542240000000",
"number": "1104392232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5745 SW 75TH ST # 507",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326085504",
"telephone_number": "352-204-5400",
"fax_number": "352-204-5405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 NW 64TH TER",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326054220",
"telephone_number": "352-204-5400",
"fax_number": "352-204-5405"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UROLOGIC INTEGRATED CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-16",
"last_updated": "2018-11-15",
"status": "A",
"authorized_official_last_name": "BIRD",
"authorized_official_first_name": "VICTORIA",
"authorized_official_middle_name": "Y",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "352-278-5132",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Urologic Integrated Care",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.