Organization Active NPI

Urology Professionals LLLP

  • Specialist
  • Trinity, FL
National Provider Identifier
1336264035
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
UROLOGY PROFESSIONALS LLLP
Practice address
2075 Little Rd
Trinity, FL 34655-4421
Phone
(727) 375-5520
Fax
(727) 375-1463
NPI assigned
Mar 20, 2007
Last updated
May 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Authorized official

Name
Dr. Juan Otheguy, MDNPI 1992760557
Title
Authorized Official
Phone
(727) 375-5520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

2075 Little Rd
Trinity, FL 34655-4421

Mailing address

2075 Little Rd
Trinity, FL 34655-4421
Phone (727) 375-5520

Other names 1

  • UROLOGY PROFESSIONALS Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070622000140 FL Part B Supplier - Clinic/Group Practice 0840399440 Receives reassigned benefits from 2 practitioners
Practice locations: Trinity, FL

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
10D1080850Urology Professionals LLP2075 Little Rd, Trinity, FL 34655Certificate of waiverJun 25, 2027

National Provider Directory

National Provider Directory

Locations

2075 Little Rd
Trinity, FL 34655
Phone (727) 375-5520

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBEDAA

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1336264035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554421",
            "telephone_number": "727-375-5520",
            "fax_number": "727-375-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554421",
            "telephone_number": "727-375-5520",
            "fax_number": "727-375-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY PROFESSIONALS LLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "OTHEGUY",
        "authorized_official_first_name": "JUAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "727-375-5520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UROLOGY PROFESSIONALS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Trinity, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.