NPIMap

Organization Active NPI

Baycare Outpatient Imaging LLC

  • Diagnostic Radiology Physician
  • Wesley Chapel, FL
National Provider Identifier
1235898529
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
BAYCARE OUTPATIENT IMAGING LLC
Practice address
4503 Bruce B. Downs Blvld.
Suite 104
Wesley Chapel, FL 33544
Phone
(813) 586-8500
NPI assigned
Dec 14, 2021
Last updated
May 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Authorized official

Name
Lynda Gorken
Title
VP Patient Financial Services
Phone
(727) 281-9202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

4503 Bruce B. Downs Blvld.
Suite 104
Wesley Chapel, FL 33544

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 281-9065

Other names 1

  • BOI WESLEY CHAPEL Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190410002311 FL Part B Supplier - Clinic/Group Practice 3577804087 Receives reassigned benefits from 177 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wesley Chapel, FL; Winter Haven, FL; Valrico, FL; Tampa, FL; Plant City, FL; Land O Lakes, FL

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
10D2272035Baycare Outpatient Imaging, LLC4503 Bruce B Downs Blvd - Ste 104, Wesley Chapel, FL 33544Certificate of waiverNov 13, 2026

National Provider Directory

National Provider Directory
Tax ID family
Baycare Outpatient Imaging LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1235898529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-281-9065",
            "fax_number": "813-635-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4503 BRUCE B. DOWNS BLVLD.",
            "address_2": "SUITE 104",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "33544",
            "telephone_number": "813-586-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYCARE OUTPATIENT IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-14",
        "last_updated": "2024-05-24",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "GORKEN",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "VP PATIENT FINANCIAL SERVICES",
        "authorized_official_telephone_number": "727-281-9202"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BOI WESLEY CHAPEL",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "BOI WESLEY CHAPEL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wesley Chapel, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.