NPIMap

Organization Active NPI

Advanced Urology Institute, LLC

  • Durable Medical Equipment & Medical Supplies
  • Oxford, FL
National Provider Identifier
1306145263
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ADVANCED UROLOGY INSTITUTE, LLC
Practice address
12109 CR 103
Oxford, FL 34484-2967
Phone
(352) 391-6494
Fax
(352) 391-6498
NPI assigned
Mar 17, 2011
Last updated
Apr 2, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANCED UROLOGY INSTITUTE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Richard Wooten
Title
Ceo
Phone
(352) 391-6494

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

12109 CR 103
Oxford, FL 34484-2967

Mailing address

12109 CR 103
Oxford, FL 34484-2967
Phone (352) 391-6494

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230503002015 FL DME Supplier - Physician - Urology 2163653585 Practice locations: Oxford, FL

Other NPIs with the same Medicare PAC ID 22

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

View all 22

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0272670Advanced Urology Institute12109 CR 103, Oxford, FL 34484AccreditationDec 22, 2027
10D1006308Advanced Urology Institute12109 CR 103, Oxford, FL 34484AccreditationJun 24, 2028

National Provider Directory

National Provider Directory
Tax ID family
Advanced Urology Institute LLC31 organizations share this tax ID, including this one
Part of
Advanced Urology Institute LLC

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1306145263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12109 CR 103",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344842967",
            "telephone_number": "352-391-6494",
            "fax_number": "352-391-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12109 CR 103",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344842967",
            "telephone_number": "352-391-6494",
            "fax_number": "352-391-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED UROLOGY INSTITUTE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED UROLOGY INSTITUTE, LLC",
        "enumeration_date": "2011-03-17",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "WOOTEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-391-6494"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oxford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.