Individual provider Active NPI

Clyde Calenso Vanterpool, MD

  • Surgery Physician
  • Sebring, FL
National Provider Identifier
1114987641
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME67760 Issued in FL
Practice address
6801 US Highway 27 N Ste C4
Sebring, FL 33870-1000
Phone
(863) 991-9060
Fax
(863) 991-9069
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME67760 FL Primary

Addresses

Primary practice location

6801 US Highway 27 N Ste C4
Sebring, FL 33870-1000

Mailing address

PO Box 9034
Sebring, FL 33872-0134
Phone (863) 835-2158

Other identifiers 1

IdentifierTypeStateIssuer
377470800MedicaidFL

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
I20051027000205 FL Practitioner - General Surgery 9335166511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Loma Linda University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6940 N Hwy 27
Sebring, FL 33870-1043
Phone (863) 991-9060

Hospital & facility affiliations

  • Adventhealth Sebring Hospital, Sebring, FL, CCN 100109
  • HCA Florida Highlands Hospital Hospital, Sebring, FL, CCN 100049

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue37
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME67760FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Surgical Partners LLC Surgery CurrentSince Jan 26, 2025 Accepting new patients
Clyde C. Vanterpool, M.D., P.a. Surgery CurrentSince Apr 20, 2023 Accepting new patients
Adventist Health System-Sunbelt Inc Surgery PastSince Mar 1, 2023 Accepting new patients

Locations

6940 US 27 N
Sebring, FL 33870
Phone (863) 214-9894

6801 US 27 N
Ste B4
Sebring, FL 33870
Phone (863) 314-8440

6801 US 27 N
Ste B1
Sebring, FL 33870
Phone (863) 382-8080

6801 US 27 N
Ste C4
Sebring, FL 33870
Phone (863) 314-6786

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1114987641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9034",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338720134",
            "telephone_number": "863-835-2158",
            "fax_number": "863-991-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 US HIGHWAY 27 N STE C4",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338701000",
            "telephone_number": "863-991-9060",
            "fax_number": "863-991-9069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANTERPOOL",
        "first_name": "CLYDE",
        "middle_name": "CALENSO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME67760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377470800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.