NPIMap

Individual provider Active NPI

Thomas J Ullo, MD

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1265502355
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME97275 Issued in FL
Practice address
29750 US Highway 19 N Ste 101
Clearwater, FL 33761-1510
Phone
(727) 786-5058
Fax
(813) 635-2639
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME97275 FL Primary

Addresses

Primary practice location

29750 US Highway 19 N Ste 101
Clearwater, FL 33761-1510

Mailing address

29750 US Highway 19 N Ste 101
Clearwater, FL 33761-1510
Phone (727) 786-5058

Other identifiers 2

IdentifierTypeStateIssuer
P00611843OtherFLRAILROAD MEDICARE PROVIDER NUMBER
279301600MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ThomasJ.Ullo@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070921000626 FL Practitioner - Family Practice 6204920135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 2004
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians
St Mark Village IncGroup PAC ID 7618035304, shared by 2 NPIs, 16 clinicians

Practice addresses (Care Compare)

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

2655 Nebraska Ave
Palm Harbor, FL 34684-2630

29750 US Hwy 19 N
Suite 101
Clearwater, FL 33761-1510
Phone (727) 786-5058

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME97275FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Aug 1, 2007 Accepting new patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Aug 1, 2007 Accepting new patients
Baycare Urgent Care, LLC Family Medicine Past 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

2995 Drew St
Bldg 2ND
Clearwater, FL 33759

29750 US Highway 19 N
Ste 101
Clearwater, FL 33761
Phone (727) 786-5058

30522 US Highway 19 N
Ste 119
Palm Harbor, FL 34684
Phone (727) 738-0220

Interoperability endpoints

  • Direct secure messaging: thomasj.ullo@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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1265502355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29750 US HIGHWAY 19 N STE 101",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337611510",
            "telephone_number": "727-786-5058",
            "fax_number": "813-635-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29750 US HIGHWAY 19 N STE 101",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337611510",
            "telephone_number": "727-786-5058",
            "fax_number": "813-635-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLO",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME97275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDER NUMBER",
            "identifier": "P00611843",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279301600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ThomasJ.Ullo@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew Street",
            "address_2": "East Bldg 2nd Floor",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.