Active NPI
Clinton Ryan Hall, M.D.
- Surgery Physician
- Winter Haven, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- ME107524
- Practice address
- 635 1St St N
Winter Haven, FL 33881-4129 - Phone
- (863) 294-0670
- NPI assigned
- May 21, 2007
- Last updated
- May 28, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ME107524 | FL | Primary |
Addresses
Primary practice location
635 1St St N
Winter Haven, FL 33881-4129
Mailing address
2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 315-7496
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | clintonr.hall@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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of South Florida College of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Ave F NE
Winter Haven, FL 33881-4131
2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060
601 1St St N
Winter Haven, FL 33881-4129
Phone (863) 298-3204
635 1St St N
Nephrology at Gessler Annex
Winter Haven, FL 33881-4129
Phone (863) 294-0670
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 23 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 77 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gessler Clinic Professional Association | Current | Accepting new patients | |
| Surgical Associates of Brevard LLC | Surgery | Past | Accepting new patients |
| Baycare Medical Group Pediatric Walk-in, LLC | Past | Accepting new patients | |
| Baycare Medical Group Pediatric Walk-in Care LLC | Past | Accepting new patients | |
| Melbourne Hma Medical Group, LLC | Surgery | Past | Accepting new patients |
Locations
601 1st St N
Winter Haven, FL 33881
Phone (863) 294-0670
635 1st St N
Winter Haven, FL 33881
Phone (863) 294-0670
Interoperability endpoints
- clintonr.hall@direct.mybaycare.org
Organizations & group practices 6
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.
-
- General Practice Physician
- Clearwater, FL
- NPI 1043269871
-
- Internal Medicine Physician
- Winter Haven, FL
- NPI 1154399533
-
- Pediatrics Physician
- Lutz, FL
- NPI 1861850117
-
- Pediatrics Physician
- Tampa, FL
- NPI 1679724488
-
- Surgery Physician
- Rockledge, FL
- NPI 1003144270
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winter Haven, FL
- NPI 1477599975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716854400000",
"number": "1306055009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2995 DREW ST FL 2",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337593012",
"telephone_number": "727-315-7496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 1ST ST N",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338814129",
"telephone_number": "863-294-0670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "CLINTON",
"middle_name": "RYAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2024-05-28",
"certification_date": "2023-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME107524",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "clintonr.hall@direct.mybaycare.org",
"affiliation": "Y",
"affiliationName": "BayCare Medical Group, Inc.",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "635 1st St N",
"city": "Winter Haven",
"state": "FL",
"country_code": "US",
"postal_code": "338814129",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.