Individual provider Active NPI

Jerry Clayton Maliot, MD

  • Nephrology Physician
  • University Park, FL
National Provider Identifier
1467764506
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME119645 Issued in FL
Practice address
7003 Lancaster CT
University Park, FL 34201-2371
Phone
(901) 233-3489
NPI assigned
Jul 6, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 40101 TN
Nephrology Physician 207RN0300X ME119645 FL Primary

Addresses

Primary practice location

7003 Lancaster CT
University Park, FL 34201-2371

Mailing address

7003 Lancaster CT
University Park, FL 34201-2371
Phone (901) 233-3489

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
I20141211001090 FL Practitioner - Internal Medicine 0345464343 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Department of HealthGroup PAC ID 3072424282, 126 clinicians

Practice addresses (Care Compare)

6950 Outreach Way
North Port, FL 34287-3405
Phone (941) 861-2900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40101TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Jun 12, 2014 Accepting new patients
Florida Department of Health Current Accepting new patients
Florida Department of Health CurrentSince Jun 12, 2014 Accepting new patients
Centerplace Health, Inc CurrentSince Sep 17, 2019 Accepting new patients

Locations

6950 Outreach Way
North Port, FL 34287
Phone (941) 529-0200

2200 Ringling Blvd
Sarasota, FL 34237
Phone (941) 861-2900

1750 17th St
Ste E
Sarasota, FL 34234
Phone (941) 529-0200

1750 17th St
Ste N
Sarasota, FL 34234
Phone (941) 529-0200

1900 Brother Geenen Way
Sarasota, FL 34236
Phone (941) 556-3215

Interoperability endpoints

  • Direct secure messaging: jerry.maliot.1@16972.direct.athenahealth.com

Organizations & group practices 4

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 1

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": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1467764506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7003 LANCASTER CT",
            "city": "UNIVERSITY PARK",
            "state": "FL",
            "postal_code": "342012371",
            "telephone_number": "901-233-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7003 LANCASTER CT",
            "city": "UNIVERSITY PARK",
            "state": "FL",
            "postal_code": "342012371",
            "telephone_number": "901-233-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIOT",
        "first_name": "JERRY",
        "middle_name": "CLAYTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TN",
            "license": "40101",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME119645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Park, FL

Sources for this page

Verify at the official NPI Registry.