Individual provider Active NPI

Richard Pentreath Hodges, MD

  • Surgery Physician
  • Tampa, FL
National Provider Identifier
1184629412
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME66033 Issued in FL
Practice address
4301 N Habana Ave
Tampa, FL 33607-6546
Phone
(813) 870-4064
Fax
(813) 443-8146
NPI assigned
Jun 14, 2005
Last updated
Dec 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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 ME66033 FL Primary

Addresses

Primary practice location

4301 N Habana Ave
Tampa, FL 33607-6546

Mailing address

PO Box 10744
Clearwater, FL 33757-8744
Phone (727) 532-0002

Other identifiers 1

IdentifierTypeStateIssuer
377334500MedicaidFL

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
I20080130000308 FL Practitioner - General Surgery 3971685991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Miami, LM Miller School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone (813) 321-6589

3003 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Surgery CurrentSince May 1, 2015 Accepting new patients
Baycare Medical Group, Inc. CurrentSince May 1, 2015 Accepting new patients
St Josephs Specialty Services Inc Surgery Past Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

4600 N Habana Ave
Ste 2
Tampa, FL 33614
Phone (813) 870-4064

Interoperability endpoints

  • Direct secure messaging: richardp.hodges@direct.mybaycare.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1184629412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10744",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337578744",
            "telephone_number": "727-532-0002",
            "fax_number": "727-266-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 N HABANA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076546",
            "telephone_number": "813-870-4064",
            "fax_number": "813-443-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "RICHARD",
        "middle_name": "PENTREATH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME66033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377334500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.