NPIMap

Individual provider Active NPI

Kevin P Lipscomb, M.D.

  • Family Medicine Physician
  • Bradenton, FL
National Provider Identifier
1285631028
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME74654 Issued in FL
Practice address
11505 Rangeland Pkwy
Bradenton, FL 34211-4041
Phone
(941) 907-6016
Fax
(941) 907-0199
NPI assigned
Jul 7, 2005
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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 ME74654 FL Primary

Addresses

Primary practice location

11505 Rangeland Pkwy
Bradenton, FL 34211-4041

Mailing address

11505 Rangeland Pkwy
Bradenton, FL 34211-4041
Phone (941) 907-6016

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kevin.Lipscomb@img.directbygreenway.com Direct

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
I20080414000246 FL Practitioner - Family Practice 2466539663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intercoastal Medical Group IncGroup PAC ID 6305730912, 176 clinicians
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

11505 Rangeland Pkwy
Bradenton, FL 34211-4041
Phone (941) 907-6016

11661 State Rd 70
Lakewood Ranch, FL 34202-9416
Phone (941) 222-0321

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intercoastal Medical Group Inc Family Medicine CurrentSince Apr 1, 2015 Accepting new patients

Locations

11505 Rangeland Pkwy
Bradenton, FL 34211
Phone (941) 907-6016

11505 Rangeland Pkwy
Fl 2
Bradenton, FL 34211

921 S Beneva Rd
Sarasota, FL 34232
Phone (941) 365-7390

943 S Beneva Rd
Ste 306
Sarasota, FL 34232
Phone (941) 362-8644

Interoperability endpoints

  • Direct secure messaging: kevin.lipscomb@img.directbygreenway.com

Organizations & group practices 1

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.

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1285631028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11505 RANGELAND PKWY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114041",
            "telephone_number": "941-907-6016",
            "fax_number": "941-907-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11505 RANGELAND PKWY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114041",
            "telephone_number": "941-907-6016",
            "fax_number": "941-907-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSCOMB",
        "first_name": "KEVIN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME74654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kevin.Lipscomb@img.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11505 Rangeland Pkwy",
            "city": "Bradenton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342114041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.