Baycare Behavioral Health Associates LLC
Organization Active NPI Psychiatry Physician · Lutz, FL
NPI 1245502152 · NPPES record last updated Mar 6, 2025
Key facts
- NPI
- 1245502152
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- BAYCARE BEHAVIORAL HEALTH ASSOCIATES LLC
- Practice address
- 21808 State Road 54
Lutz, FL 33549-6923 - Phone
- (727) 315-6974
- Fax
- (813) 635-2613
- NPI assigned
- Feb 8, 2012
- Organization subpart
- No
Authorized official
- Name
- Ms. Lynda Gorken
- Title
- VP
- Phone
- (727) 281-9202
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 1
Practitioners 245
-
Dawit Amare, D.O., M.A., M.P.H.
-
Shena Ayobello, MD
-
Lauren Berrios, PSY.D.
-
Brenda G Burnett, D.O.
-
Jenny Chang, DO
-
Andrew Chu, DO
-
Sapna Dhawan, MD, OT
-
Adrienne R Eisner, M.D.
-
Sarah McMillen Fayad, M.D.
-
Wil Edvard Germain, M.D.
-
Nicholas Gilliam, DO
-
Praveen K Gootam, M.D.
-
Kimberly E Hartney, M.D.
-
Yasna Jasmine Heravi-Burgos, PSY.D.
-
Amy Marie Hernandez, M.D.
-
Kazi Firoz Hossain, M.D.
-
Troy Douglas Howell, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120502000477 | FL | Part B Supplier - Clinic/Group Practice | 2567624836 |
Receives reassigned benefits from 234 practitioners 1 other NPI on this enrollment Practice locations: Tampa, FL; St Petersburg, FL; Safety Harbor, FL; Plant City, FL; Lutz, FL; New Port Richey, FL; Belleair, FL; Clearwater, FL… |
National Provider Directory
- Tax ID family
- Baycare Behavioral Health Associates LLC
Locations
300 Pinellas St
Stop 70
Clearwater, FL 33756
Networks
- HealthSun Health Plans Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | FL | Yes |
Addresses
Primary practice location
21808 State Road 54
Lutz, FL 33549-6923
Mailing address
2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 315-6974
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004874800 | Medicaid | FL |
Other providers in Lutz, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.