Active NPI
Keith Edward Baribault, MD
- Dermatopathology (Pathology) Physician
- Tampa, FL
National Provider Identifier
1376785923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatopathology (Pathology) Physician
- License
- 239324
- Practice address
- 10500 University Center Dr Ste 200
Tampa, FL 33612-6497 - Phone
- (800) 929-6694
- NPI assigned
- Mar 28, 2009
- 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 |
|---|---|---|---|---|
| Dermatopathology (Pathology) Physician | 207ZD0900X | 239324 | NY | Primary |
Addresses
Primary practice location
10500 University Center Dr Ste 200
Tampa, FL 33612-6497
Mailing address
14275 Midway Rd
Suite 400
Addison, TX 75001-3614
Phone (800) 942-3376
Other practice location 1
100 Midland Ave
Port Chester, NY 10573-4943
Phone (800) 942-3376
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 239324 | NY | MD | Dermatopathology (Pathology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ameripath New York LLC | Past | Accepting new patients | |
| Ameripath New York LLC | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Organizations & group practices 2
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.
-
- Clinical Medical Laboratory
- White Plains, NY
- NPI 1043282841
-
- Clinical Medical Laboratory
- Mount Kisco, NY
- NPI 1962223370
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1376785923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14275 MIDWAY RD",
"address_2": "SUITE 400",
"city": "ADDISON",
"state": "TX",
"postal_code": "750013614",
"telephone_number": "800-942-3376",
"fax_number": "610-271-4245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10500 UNIVERSITY CENTER DR STE 200",
"city": "TAMPA",
"state": "FL",
"postal_code": "336126497",
"telephone_number": "800-929-6694"
}
],
"practiceLocations": [
{
"address_1": "100 Midland Ave",
"address_purpose": "LOCATION",
"city": "Port Chester",
"state": "NY",
"postal_code": "105734943",
"country_code": "US",
"telephone_number": "800-942-3376",
"fax_number": "914-934-9819",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BARIBAULT",
"first_name": "KEITH",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-28",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207ZD0900X",
"taxonomy_group": "",
"desc": "Pathology, Dermatopathology",
"state": "NY",
"license": "239324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.