NPIMap

West Florida Medical Associates, PA

Organization Active NPI Rural Health Clinic/Center · Inglis, FL

NPI 1437755345 · NPPES record last updated Dec 7, 2020

Key facts

NPI
1437755345
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
WEST FLORIDA MEDICAL ASSOCIATES, PA
Practice address
41 N Inglis Ave Ste B
Inglis, FL 34449-9463
Phone
(352) 447-2122
Fax
(352) 465-7576
NPI assigned
Dec 7, 2020
Organization subpart
Yes
Parent organization (as reported)
WEST FLORIDA MEDICAL ASSOCIATES, PA

Authorized official

Name
Ulhas T Deven, MD
Title
President
Phone
(352) 464-0762

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Rural health clinic certification: CCN 683839

Legal name
WEST FLORIDA MEDICAL ASSOCIATES, PA
Doing business as
DEVEN MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 20, 2021
Last certification
Apr 12, 2021
Ownership / control type
1A
Organization structure
Corporation · Proprietary
Incorporated
Nov 15, 1999 in FL
Enrollment address
41 N Inglis Ave, Ste B
Inglis, FL 34449-9463

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Uday Hiremath
Individual 		5% Or Greater Direct Ownership Interest Oct 13, 2022 100%
Ulhas Tarikere Deven
Individual 		W-2 Managing Employee
Owner/MD		 Dec 1, 2020 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20201216000045 FL Part a Provider - Rural Health Clinic 9032023221 Practice locations: Inglis, FL

National Provider Directory

Tax ID family
Lri Medical (28 organizations share this tax ID)
Part of
Lri Medical

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

41 N Inglis Ave Ste B
Inglis, FL 34449-9463

Mailing address

3920 N Grayhawk Loop
Lecanto, FL 34461-8471
Phone (352) 464-0762

Other names

  • Deven Medical Clinic Doing business as

Other providers in Inglis, FL

All providers in Inglis, FL · Rural Health Clinic/Center in Florida

Sources for this page

Verify at the official NPI Registry.