NPIMap

Advanced Urology Institute, LLC

Organization Active NPI Durable Medical Equipment & Medical Supplies · Oxford, FL

NPI 1306145263 · NPPES record last updated Apr 2, 2024

Key facts

NPI
1306145263
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 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
Organization subpart
Yes
Parent organization (as reported)
ADVANCED UROLOGY INSTITUTE, LLC

Authorized official

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

Other NPIs with the same Medicare PAC ID 22

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

Corporate family (same tax ID) 30

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

View all 30

Practitioners 152

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 152

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0272670Advanced Urology Institute
12109 CR 103, Oxford, FL 34484		AccreditationDec 22, 2027
10D1006308Advanced Urology Institute
12109 CR 103, Oxford, FL 34484		AccreditationJun 24, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

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

National Provider Directory

Tax ID family
Advanced Urology Ins LLC (31 organizations share this tax ID)
Part of
Advanced Urology Ins LLC

Specialties & licenses

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

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

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

Other providers in Oxford, FL

All providers in Oxford, FL · Durable Medical Equipment & Medical Supplies in Florida

Sources for this page

Verify at the official NPI Registry.