Organization Active NPI

Baycare Medical Group, Inc

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1497117329
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BAYCARE MEDICAL GROUP, INC
Practice address
2995 Drew Street
East BLDG 2ND Floor
Clearwater, FL 33759
Phone
(727) 532-1355
NPI assigned
Mar 21, 2016
Last updated
Jan 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Authorized official

Name
Ms. Lynda A. Gorken
Title
VP, PFS
Phone
(727) 532-1355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

2995 Drew Street
East BLDG 2ND Floor
Clearwater, FL 33759

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 281-9065

Other identifiers 1

IdentifierTypeStateIssuer
263650600MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031216000718 FL Part B Supplier - Clinic/Group Practice 6406753623 Receives reassigned benefits from 2,106 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2000 Osprey Blvd
Ste 205
Bartow, FL 33830
Phone (863) 519-1799

29750 US Highway 19 N
Ste 101
Clearwater, FL 33761
Phone (727) 467-2502

18600 Fernview St
Ste 102
Land O Lakes, FL 34638
Phone (813) 692-8033

12899 Walsingham Rd
Largo, FL 33774
Phone (727) 596-9490

4211 Van Dyke Rd
Ste 101
Lutz, FL 33558
Phone (813) 960-4026

10627 Rhodine Rd
Riverview, FL 33578
Phone (813) 605-3235

6901 Simmons Loop
Fl 4
Riverview, FL 33578
Phone (813) 302-8388

10799 Park Blvd
Seminole, FL 33772
Phone (727) 319-0180

1919 W Swann Ave
Fl 2
Tampa, FL 33606
Phone (813) 254-7078

4541 S Dale Mabry Hwy
Ste 100
Tampa, FL 33611
Phone (813) 533-7030

2102 Trinity Oaks Blvd
#202
Trinity, FL 34655
Phone (727) 315-6775

2529 Cypress Ridge Blvd
Wesley Chapel, FL 33544
Phone (813) 920-1800

200 Avenue F NE
Ste 9118
Winter Haven, FL 33881
Phone (863) 292-4004

Practitioners & affiliated clinicians

Practitioners 639

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 639

NPI Registry JSON

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

{
    "created_epoch": "1458518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642982400000",
    "number": "1497117329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-281-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2995 DREW STREET",
            "address_2": "EAST BLDG 2ND FLOOR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33759",
            "telephone_number": "727-532-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYCARE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-21",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "GORKEN",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "VP, PFS",
        "authorized_official_telephone_number": "727-532-1355",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263650600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.