Active NPI
Babette M Pachence, MD
- Internal Medicine Physician
- Bradenton, FL
National Provider Identifier
1417034810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME109083
- Practice address
- 2424 Manatee Ave W Ste 100
Bradenton, FL 34205-4954 - Phone
- (941) 847-7920
- Fax
- (941) 757-2291
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- 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 | MA43525 | NJ | |
| Internal Medicine Physician | 207R00000X | ME109083 | FL | Primary |
Addresses
Primary practice location
2424 Manatee Ave W Ste 100
Bradenton, FL 34205-4954
Mailing address
10051 5TH St N Ste 200
Saint Petersburg, FL 33702-2211
Phone (727) 824-0780
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9417572291 | Medicaid | FL |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME109083 | FL | MD | Internal Medicine Physician |
| MA43525 | NJ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCR Health, Inc. | Current | Accepting new patients | |
| MCR Health, Inc. | Current | Accepting new patients | |
| Optumcare Florida Ci, LLC | Past | Accepting new patients | |
| Saint Peter'S University Hospital | Past | Accepting new patients | |
| Head & Neck Oncology Group of Central Jersey | Past | Accepting new patients |
Locations
701 Manatee Ave W
Ste 101
Bradenton, FL 34205
Phone (941) 748-3065
700 8th Ave W
Ste 101
Palmetto, FL 34221
Phone (941) 776-4008
12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231
Interoperability endpoints
- https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4
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.
-
- Federally Qualified Health Center (FQHC)
- Parrish, FL
- NPI 1255376000
-
- Non-Pharmacy Dispensing Site
- Bradenton, FL
- NPI 1821878745
-
- Primary Care Clinic/Center
- Winter Park, FL
- NPI 1720506603
-
- Oncology Clinic/Center
- New Brunswick, NJ
- NPI 1063628113
-
- General Acute Care Hospital
- New Brunswick, NJ
- NPI 1114924834
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598572800000",
"number": "1417034810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10051 5TH ST N STE 200",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337022211",
"telephone_number": "727-824-0780",
"fax_number": "727-568-6011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2424 MANATEE AVE W STE 100",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342054954",
"telephone_number": "941-847-7920",
"fax_number": "941-757-2291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACHENCE",
"first_name": "BABETTE",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2020-08-28",
"certification_date": "2020-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "MA43525",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME109083",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9417572291",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.