Individual provider Active NPI

Justin Deptula, D.O.

  • Internal Medicine Physician
  • Hudson, FL
National Provider Identifier
1386094910
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS15870 Issued in FL
Practice address
14000 Fivay Rd
Hudson, FL 34667-7103
Phone
(727) 869-5400
Fax
(727) 819-2908
NPI assigned
Jun 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS15870 FL Primary

Addresses

Primary practice location

14000 Fivay Rd
Hudson, FL 34667-7103

Mailing address

14000 Fivay Rd
Hudson, FL 34667-7103
Phone (727) 869-5400

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
I20190708000806 FL Practitioner - Internal Medicine 0345533675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of FL, LLCGroup PAC ID 9234596743, 513 clinicians

Practice addresses (Care Compare)

14000 Fivay Rd
Hudson, FL 34667-7103
Phone (727) 819-2929

340 NW Commerce Dr
Lake City Medical Center
Lake City, FL 32055-4709
Phone (850) 719-9000

Hospital & facility affiliations

  • HCA Florida Bayonet Point Hospital Hospital, Hudson, FL, CCN 100256
  • HCA Florida Oak Hill Hospital Hospital, Brooksville, FL, CCN 100264

Merit-based Incentive Payment System (MIPS)

Final score
90.95 of 100Reported as group
Quality
78.21
Promoting interoperability
100
Improvement activities
40
Cost
77.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS15870FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
S M S DO PA Internal Medicine PastSince Oct 16, 2023 Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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.

Hospital & facility affiliations 2

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": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1386094910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14000 FIVAY RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677103",
            "telephone_number": "727-869-5400",
            "fax_number": "888-706-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 FIVAY RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677103",
            "telephone_number": "727-869-5400",
            "fax_number": "727-819-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPTULA",
        "first_name": "JUSTIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS15870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

Verify at the official NPI Registry.