NPIMap

Organization Active NPI

Ohi West Medical Group, LLC

Doing business as Bayfront Health St. Petersburg Imaging Center

  • Radiology Clinic/Center
  • St Petersburg, FL
National Provider Identifier
1285240192
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
OHI WEST MEDICAL GROUP, LLC
Doing business as
Bayfront Health St. Petersburg Imaging Center
Practice address
2201 Central Ave Ste 100
St Petersburg, FL 33713-8844
Phone
(727) 893-6050
Fax
(727) 893-6046
NPI assigned
Sep 17, 2020
Last updated
Oct 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Authorized official

Name
Yesenia Mosher
Title
Sr. Director, Ohri
Phone
(321) 842-3777

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary
Diagnostic Radiology Physician 2085R0202X

Addresses

Primary practice location

2201 Central Ave Ste 100
St Petersburg, FL 33713-8844

Mailing address

3090 Caruso CT Ste 50
Orlando, FL 32806-8510
Phone (407) 481-7174

Other names 1

  • Bayfront Health St. Petersburg Imaging Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210225002410 FL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2668882507 Practice locations: St Petersburg, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1800 66th St N
Ste 100
St Petersburg, FL 33710
Phone (727) 893-6323

470 2nd St S
St Petersburg, FL 33701
Phone (727) 893-6060

601 7th St S
Ste 205
St Petersburg, FL 33701
Phone (727) 893-6234

601 7th St S
Ste 405
St Petersburg, FL 33701
Phone (727) 553-7450

603 7th St S
Ste 440
St Petersburg, FL 33701
Phone (727) 553-7420

625 6th Ave S
Ste 430
St Petersburg, FL 33701
Phone (727) 553-7344

725 6th Ave S
Ste 1200
St Petersburg, FL 33701
Phone (727) 553-7355

Practitioners & affiliated clinicians

Practitioners 254

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 254

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1285240192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 CARUSO CT STE 50",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328068510",
            "telephone_number": "407-481-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 CENTRAL AVE STE 100",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138844",
            "telephone_number": "727-893-6050",
            "fax_number": "727-893-6046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHI WEST MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-17",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "MOSHER",
        "authorized_official_first_name": "YESENIA",
        "authorized_official_title_or_position": "SR. DIRECTOR, OHRI",
        "authorized_official_telephone_number": "321-842-3777"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayfront Health St. Petersburg Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.