Organization Active NPI

Family Care Inc

  • Primary Care Clinic/Center
  • Bradenton, FL
National Provider Identifier
1487913133
Registry record updated Dec 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
ME0071369 Issued in FL
Legal business name
FAMILY CARE INC
Practice address
6078 14TH St W
Bradenton, FL 34207-4104
Phone
(941) 752-1400
Fax
(941) 752-0192
NPI assigned
May 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2012

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

Authorized official

Name
Dr. Asad Moiz Ali, M.D.NPI 1790715233
Title
Medical Doctor/Owner
Phone
(941) 752-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ME0071369 FL Primary

Addresses

Primary practice location

6078 14TH St W
Bradenton, FL 34207-4104

Mailing address

6078 14TH St W
Bradenton, FL 34207
Phone (941) 752-1400

Other identifiers 1

IdentifierTypeStateIssuer
250563100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120518000218 FL Part B Supplier - Clinic/Group Practice 8224291851 Receives reassigned benefits from 1 practitioner
Practice locations: Bradenton, FL; Palmetto, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0939633Family Care Inc6078 14TH Street West, Bradenton, FL 34207Certificate of waiverJan 28, 2028

National Provider Directory

National Provider Directory

Locations

2302 59th St W
Bradenton, FL 34209
Phone (941) 792-8480

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356048000000",
    "number": "1487913133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6078 14TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34207",
            "telephone_number": "941-752-1400",
            "fax_number": "941-752-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6078 14TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342074104",
            "telephone_number": "941-752-1400",
            "fax_number": "941-752-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-12-21",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "ASAD",
        "authorized_official_middle_name": "MOIZ",
        "authorized_official_title_or_position": "MEDICAL DOCTOR/OWNER",
        "authorized_official_telephone_number": "941-752-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME0071369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250563100",
            "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 Dec 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.