NPIMap

Organization Active NPI

West Florida Medical Associates, PA

  • Rural Health Clinic/Center
  • Dunnellon, FL
National Provider Identifier
1154475200
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
ME0060472 Issued in FL
Legal business name
WEST FLORIDA MEDICAL ASSOCIATES, PA
Practice address
20021 SW 111TH PL
Dunnellon, FL 34432-4786
Phone
(352) 465-1199
Fax
(352) 465-1207
NPI assigned
Jan 23, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Rajendra P Bellam, M.D.NPI 1053392969
Title
President
Phone
(352) 465-1199

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs with the same Medicare PAC ID 16

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

Corporate family (same tax ID) 27

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

View all 27

Practitioners 24

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0718243Bellam Medical Clinic20021 SW 111TH PL, Dunnellon, FL 34432Certificate of waiverApr 9, 2027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Rural health clinic certification: CCN 103944

Medicare enrollment files
Legal name
WEST FLORIDA MEDICAL ASSOCIATES, PA
Doing business as
BELLAM MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 23, 1996
Last certification
Aug 22, 2023
Ownership / control type
1A
Organization structure
CorporationProprietary
Incorporated
Jun 5, 1997 in FL
Enrollment address
20021 SW 111TH PL
Dunnellon, FL 34432-4786

All disclosed owners & managing parties 1

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Rajendra Bellam Individual 5% Or Greater Direct Ownership Interest Sep 1, 2010 100%
W-2 Managing EmployeeAd;MD;Owner Sep 1, 2010 100%

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20101108001127 FL Part a Provider - Rural Health Clinic 9032023221 Practice locations: Dunnellon, FL

National Provider Directory

National Provider Directory
Tax ID family
Lri Medical (28 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X ME0060472 FL Primary

Addresses

NPPES NPI Registry

Primary practice location

20021 SW 111TH PL
Dunnellon, FL 34432-4786

Mailing address

PO Box 640573
Beverly Hills, FL 34464-0573
Phone (352) 746-1558

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
660072700MedicaidFL

Other names 1

NPPES NPI Registry
  • Bellam Medical Clinic Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 23, 2025.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1154475200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640573",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344640573",
            "telephone_number": "352-746-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20021 SW 111TH PL",
            "city": "DUNNELLON",
            "state": "FL",
            "postal_code": "344324786",
            "telephone_number": "352-465-1199",
            "fax_number": "352-465-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST FLORIDA MEDICAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "BELLAM",
        "authorized_official_first_name": "RAJENDRA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-465-1199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "FL",
            "license": "ME0060472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660072700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bellam Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dunnellon, FL

Sources for this page

Verify at the official NPI Registry.