Individual provider Active NPI

Jeffrey Zack Mildrum, MD

  • Family Medicine Physician
  • Largo, FL
National Provider Identifier
1336609692
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME154956 Issued in FL
Practice address
13670 Walsingham Rd
Largo, FL 33774-3532
Phone
(727) 593-9848
Fax
(727) 596-4532
NPI assigned
Mar 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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 ME154956 FL Primary

Addresses

Primary practice location

13670 Walsingham Rd
Largo, FL 33774-3532

Mailing address

13670 Walsingham Rd
Largo, FL 33774-3532
Phone (727) 593-9848

Other practice location 1

36245 US Hwy 27 N
Haines City, FL 33844-3744
Phone (863) 866-9933

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jeffrey.MildrumMD@direct.mybaycare.org Health Information Exchange (HIE) BayCare Urgent Care, LLC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220624001145 FL Practitioner - Family Practice 8022497890 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Urgent Care, LLC.Group PAC ID 6103841051, 91 clinicians

Practice addresses (Care Compare)

2331 4TH St N
St Petersburg, FL 33704-2801
Phone (727) 914-8566

2645 S Florida Ave
Lakeland, FL 33803-3829
Phone (863) 606-6880

36245 Hwy 27
Haines City, FL 33844-3744
Phone (863) 866-9933

400 1St St N
Winter Haven
Winter Haven, FL 33881-4115
Phone (863) 299-2420

Hospital & facility affiliations

  • Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME154956FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Urgent Care, LLC Family Medicine CurrentSince Jun 21, 2022 Accepting new patients
Baycare Urgent Care, LLC Family Medicine Current Accepting new patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Jun 21, 2022 Accepting new patients
Baycare Medical Group, Inc Family Medicine CurrentSince Jun 21, 2022 Accepting new patients
Baycare Medical Group, Inc. Family Medicine Current Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

36245 US Hwy 27 N
Haines City, FL 33844
Phone (863) 421-9801

13670 Walsingham Rd
Largo, FL 33774
Phone (727) 593-9848

4821 US Highway 19
Ste 5
New Port Richey, FL 34652
Phone (727) 851-9650

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

2331 4th St N
St Petersburg, FL 33704
Phone (727) 593-9848

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jeffrey.mildrummd@direct.mybaycare.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1336609692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13670 WALSINGHAM RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337743532",
            "telephone_number": "727-593-9848",
            "fax_number": "727-596-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13670 WALSINGHAM RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337743532",
            "telephone_number": "727-593-9848",
            "fax_number": "727-596-4532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36245 US Hwy 27 N",
            "address_purpose": "LOCATION",
            "city": "Haines City",
            "state": "FL",
            "postal_code": "338443744",
            "country_code": "US",
            "telephone_number": "863-866-9933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILDRUM",
        "first_name": "JEFFREY",
        "middle_name": "ZACK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME154956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jeffrey.MildrumMD@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Urgent Care, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew St Fl 2",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337593012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.