Advanced Urology Institute LLC

Organization Active NPI Durable Medical Equipment & Medical Supplies · New Smyrna Beach, FL

NPI 1134830763 · NPPES record last updated Apr 2, 2024

Key facts

NPI
1134830763
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
ADVANCED UROLOGY INSTITUTE LLC
Practice address
506 Palmetto St
New Smyrna Beach, FL 32168-7325
Phone
(386) 427-9554
NPI assigned
Dec 5, 2022
Organization subpart
Yes
Parent organization (as reported)
ADVANCED UROLOGY INSTITUTE LLC

Authorized official

Name
Richard Wooten
Title
Ceo
Phone
(919) 397-8768

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

Practitioners 152

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 152

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230307001451 FL DME Supplier - Physician - Urology 2163653585 Practice locations: New Smyrna Beach, FL

National Provider Directory

Tax ID family
Advanced Urology Ins LLC (31 organizations share this tax ID)
Part of
Advanced Urology Ins LLC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Yes

Addresses

Primary practice location

506 Palmetto St
New Smyrna Beach, FL 32168-7325

Mailing address

506 Palmetto St
New Smyrna Beach, FL 32168-7325
Phone (386) 427-9554

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Other providers in New Smyrna Beach, FL

All providers in New Smyrna Beach, FL · Durable Medical Equipment & Medical Supplies in Florida

Sources for this page

Verify at the official NPI Registry.