Individual provider Active NPI

Nathan P Falk, MD

  • Family Medicine Physician
  • Winter Haven, FL
National Provider Identifier
1245434299
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME124263 Issued in FL
Practice address
1201 1St St S Ste 100a
Winter Haven, FL 33880-3904
Phone
(863) 280-6080
Fax
(863) 229-7587
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X ME 124263 FL
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X ME124263 FL Primary

Addresses

Primary practice location

1201 1St St S Ste 100a
Winter Haven, FL 33880-3904

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 532-1355

Other identifiers 1

IdentifierTypeStateIssuer
016940700MedicaidFL

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
I20150904001327 FL Practitioner - Sports MedicinePractitioner - Family Practice 2961671813 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
University of Nebraska College of Medicine, 2007
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)

1201 1St St S
Suite 100a
Winter Haven, FL 33880-3904
Phone (863) 280-6080

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME124263FLMDFamily Medicine Physician
ME 124263FLMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Jul 1, 2019 Accepting new patients
Adventist Health System Sunbelt Inc Family Medicine CurrentSince May 2, 2016 Accepting new patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Jul 1, 2019 Accepting new patients
Adventist Health System-Sunbelt, Inc CurrentSince May 2, 2016 Accepting new patients
Florida Hospital Medical Group Inc Family Medicine CurrentSince Feb 28, 2017 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 28, 2017 Accepting new patients

Locations

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

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

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

7975 Lake Underhill Rd
Ste 200
Orlando, FL 32822
Phone (407) 303-5990

2501 N Orange Ave
Ste 235
Orlando, FL 32804
Phone (407) 303-1967

1201 1st St S
Ste 100A
Winter Haven, FL 33880
Phone (863) 280-6080

200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652

1201 1st St S
Winter Haven, FL 33880
Phone (863) 294-7062

133 Benmore Dr
Ste 200
Winter Park, FL 32792
Phone (407) 599-6060

Interoperability endpoints

  • Direct secure messaging: nathan.falk@direct.mybaycare.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1245434299",
    "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": "727-532-1355",
            "fax_number": "813-635-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 1ST ST S STE 100A",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803904",
            "telephone_number": "863-280-6080",
            "fax_number": "863-229-7587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALK",
        "first_name": "NATHAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME 124263",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME124263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016940700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.