NPIMap

West Florida Medical Associates P a

Organization Active NPI Rural Health Clinic/Center · Hernando, FL

NPI 1164560124 · NPPES record last updated Oct 12, 2010

Key facts

NPI
1164560124
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
License
ME0050533 (FL)
Legal business name
WEST FLORIDA MEDICAL ASSOCIATES P A
Practice address
2669 N Florida Ave
Hernando, FL 34442
Phone
(352) 637-2550
Fax
(352) 637-2551
NPI assigned
Feb 2, 2007
Organization subpart
No

Authorized official

Name
Dr. Shirishkumar G Patel, MD
Title
Physician
Phone
(352) 637-2550

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Rural health clinic certification: CCN 103969

Legal name
WEST FLORIDA MEDICAL ASSOCIATES, PA
Doing business as
HERNANDO MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 23, 1997
Last certification
Sep 6, 2023
Ownership / control type
1B
Organization structure
Corporation · Proprietary
Incorporated
Jun 5, 1997 in FL
Enrollment address
2669N Florida Ave
Hernando, FL 34442-4331

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Uday Hiremath
Individual 		5% Or Greater Direct Ownership Interest Oct 13, 2022 100%
Shirishkuma G Patel
Individual 		W-2 Managing Employee
Administrator		 Jun 5, 1997

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20101012000837 FL Part a Provider - Rural Health Clinic 9032023221 Practice locations: Hernando, FL

National Provider Directory

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X ME0050533 FL Yes

Addresses

Primary practice location

2669 N Florida Ave
Hernando, FL 34442

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
660089100MedicaidFL

Other names

  • Hernando Medical Clinic Doing business as

Other providers in Hernando, FL

All providers in Hernando, FL · Rural Health Clinic/Center in Florida

Sources for this page

Verify at the official NPI Registry.