Individual provider Active NPI

Daniel Theodore McClenathan, MD

  • Pediatric Gastroenterology Physician
  • St Petersburg, FL
National Provider Identifier
1275511669
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
ME0042464 Issued in FL
Practice address
601 5TH St S
Suite #605
St Petersburg, FL 33701-4804
Phone
(727) 822-4300
Fax
(727) 456-1399
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X ME0042464 FL Primary

Addresses

Primary practice location

601 5TH St S
Suite #605
St Petersburg, FL 33701-4804

Mailing address

2901 58TH Ave N
St Petersburg, FL 33714-1326
Phone (727) 822-4300

Other identifiers 1

IdentifierTypeStateIssuer
067720500MedicaidFL

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
I20050511000238 FL Practitioner - GastroenterologyPractitioner - Pediatric Medicine 7719927888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Pediatric Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Physician Services, Inc.Group PAC ID 7113989849, 200 clinicians

Practice addresses (Care Compare)

601 5TH St S
Suite 5
St Petersburg, FL 33701-4804
Phone (727) 727-4429

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0042464FLMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Physician Services, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Pediatric Gastroenterology Hepatology & Nutrition of FL P a Pediatric Gastroenterology CurrentSince May 9, 2005 Accepting new patients

Locations

9400 Gladiolus Dr
Ste 100
Fort Myers, FL 33908
Phone (239) 223-0484

3310 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 802-6600

5640 Main St
New Pt Richey, FL 34652
Phone (727) 822-4300

601 5th St S
Ste 5
St Petersburg, FL 33701
Phone (727) 727-4429

2901 58th Ave N
St Petersburg, FL 33714

601 5th St S
Ste 605
St Petersburg, FL 33701
Phone (727) 822-4300

601 5th St S
St Petersburg, FL 33701
Phone (727) 767-3333

501 6th Ave S
St Petersburg, FL 33701
Phone (727) 344-6060

3003 W Mlk Blvd
Tampa, FL 33607
Phone (813) 357-0630

Interoperability endpoints

  • Direct secure messaging: dmcclenathan734696@direct.hopkinsmedicine.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1275511669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 58TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337141326",
            "telephone_number": "727-822-4300",
            "fax_number": "727-456-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH ST S",
            "address_2": "SUITE #605",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-822-4300",
            "fax_number": "727-456-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENATHAN",
        "first_name": "DANIEL",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME0042464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067720500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.