Active NPI
David J Widmyer, D.O.
- Nephrology Physician
- Venice, FL
National Provider Identifier
1396972246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- OS15121
- Practice address
- 1500 E Venice Ave Unit 103
Venice, FL 34292 - Phone
- (941) 485-4700
- Fax
- (941) 485-2888
- NPI assigned
- Jun 18, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | OS016250 | PA | |
| Nephrology Physician | 207RN0300X | OS15121 | FL | Primary |
Addresses
Primary practice location
1500 E Venice Ave Unit 103
Venice, FL 34292
Mailing address
1500 E Venice Ave Unit 103
Venice, FL 34292-1663
Phone (941) 485-4700
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Lake Erie College of Osteopathic Medicine, Erie, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 E Venice Ave
Unit 103
Venice, FL 34292-1663
Phone (813) 910-0030
Hospital & facility affiliations
- FMC - Venice
- Fresenius Kidney Care East Venice
- DaVita Venice Dialysis Center
- Sarasota Memorial Hospital - Venice
- Sarasota Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.33 of 100
- Quality
- 70.52
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.91
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS15121 | FL | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Kidney Physicians , LLC | Nephrology | Current | Accepting new patients |
| Florida Kidney Physicians, LLC | Nephrology | Current | Accepting new patients |
| Einstein Practice Plan Inc | Internal Medicine | Past | Accepting new patients |
Locations
12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708
1500 E Venice Ave
Unit 103
Venice, FL 34292
Phone (941) 416-7734
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- david.widmyer.1@15644.direct.athenahealth.com
- https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4
Organizations & group practices 3
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.
-
- Nephrology Physician
- Temple Terrace, FL
- NPI 1760831564
-
- Nephrology Physician
- Melbourne, FL
- NPI 1205506722
-
- Internal Medicine Physician
- Philadelphia, PA
- NPI 1801853288
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Venice, FL
- NPI 1326698515
Dialysis facility
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Venice, FL
- NPI 1407192339
Dialysis facility
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Venice, FL
- NPI 1609844943
Dialysis facility
-
- General Acute Care Hospital
- North Venice, FL
- NPI 1013534445
-
- General Acute Care Hospital
- Sarasota, FL
- NPI 1245294826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535414400000",
"number": "1396972246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 E VENICE AVE UNIT 103",
"city": "VENICE",
"state": "FL",
"postal_code": "342921663",
"telephone_number": "941-485-4700",
"fax_number": "941-485-2888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E VENICE AVE UNIT 103",
"city": "VENICE",
"state": "FL",
"postal_code": "34292",
"telephone_number": "941-485-4700",
"fax_number": "941-485-2888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDMYER",
"first_name": "DAVID",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-18",
"last_updated": "2018-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "OS016250",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "FL",
"license": "OS15121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venice, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.