Diagnostic Clinic Medical Group Inc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

DIAGNOSTIC CLINIC MEDICAL GROUP INC

Practice address

3165 N McMullen Booth Rd
Building B
Clearwater, FL 33761-2032

Phone

(727) 581-8767

Fax

(727) 581-8507

NPI assigned

Jan 13, 2014

Last updated

Nov 25, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gina M Prebeck

Title

VP of Operations

Phone

(727) 581-8767

Specialties & licenses 2

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Diagnostic Clinic Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Largo, FL
  • NPI 1730232240

  Member Of

  NPD member

Locations

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lazaro T Almeida, P.A.-C.

  • Medical Physician Assistant
  • Trinity, FL
  • NPI 1881623353
  NPD
• Catherine M Barber, PA-C

  • Medical Physician Assistant
  • Largo, FL
  • NPI 1427087055
  NPD
• Timothy Judge Frost, PA-C

  • Physician Assistant
  • Tampa, FL
  • NPI 1447527692
  NPD
• Sandra M Kozlowski, P.A.-C.

  • Physician Assistant
  • Largo, FL
  • NPI 1558390955
  NPD
• Michael R Lorello, P.A.

  • Physician Assistant
  • Largo, FL
  • NPI 1710969597
  NPD
• Jennifer McCleary, PA-C

  • Physician Assistant
  • Largo, FL
  • NPI 1861938334
  NPD
• Ann Marie McManus, PA

  • Physician Assistant
  • St Petersburg, FL
  • NPI 1831412774
  NPD
• Natalie Restrepo

  • Physician Assistant
  • Largo, FL
  • NPI 1568935971
  NPD
• Natalie Eudora Bastien, ARNP

  • Nurse Practitioner
  • Trinity, FL
  • NPI 1013102409
  NPD (past)
• Luke Anthony Brown, CRNP

  • Nurse Practitioner
  • New Smyrna Beach, FL
  • NPI 1669786125
  NPD (past)
• Barbara J Courson, ARNP

  • Nurse Practitioner
  • Largo, FL
  • NPI 1548312978
  NPD (past)
• Kimberly Martin Heagy, RPH

  • Pharmacist
  • Largo, FL
  • NPI 1376528349
  NPD (past)

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1124440912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3165 N MCMULLEN BOOTH RD",
            "address_2": "BUILDING B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612032",
            "telephone_number": "727-581-8767",
            "fax_number": "727-581-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 N MCMULLEN BOOTH RD",
            "address_2": "BUILDING B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612032",
            "telephone_number": "727-581-8767",
            "fax_number": "727-581-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC CLINIC MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-13",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "PREBECK",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "727-581-8767"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dharamraj Inc (Kenneth S. Dharamraj, M.D.)
• Kenneth S Dharamraj, M.D.
• Celia P Di Marco, MD
• Joel A. Di Santi, DPM
• Diabetic Medic, Inc
• Diagnostic Clinic Medical Group Inc.
• Walter Francis Diak III, PH.D.
• Diamond Business Ventures, Inc (Zounds Hearing of Tampa Bay)
• Diana Summers Denta
• Alejandra Diaz, PHARMD.

• Gastroenterology Physician in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.