Individual provider Active NPI

Luis A. Urrutia, M.D.

  • Family Medicine Physician
  • Bradenton, FL
National Provider Identifier
1508849829
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0064527 Issued in FL
Practice address
1720 Manatee Ave E
Bradenton, FL 34208-1452
Phone
(941) 747-4661
Fax
(941) 746-5058
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0064527 FL Primary

Addresses

Primary practice location

1720 Manatee Ave E
Bradenton, FL 34208-1452

Mailing address

700 8TH Ave W Ste 101
Palmetto, FL 34221-4737
Phone (941) 776-4000

Other identifiers 2

IdentifierTypeStateIssuer
023444900MedicaidFL
278236700MedicaidFL

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
I20050805000490 FL Practitioner - Family Practice 8628007093 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0064527FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carespot of Orlando Hsi Urgent Care LLC Family Medicine CurrentSince Apr 16, 2020 Accepting new patients
MCR Health, Inc. CurrentSince Jan 30, 2020 Accepting new patients
MCR Health, Inc. Family Medicine CurrentSince Jan 30, 2020 Accepting new patients
Shands/Solantic Joint Venture, LLC CurrentSince Mar 16, 2020 Accepting new patients

Locations

3840 State Road 436
Ste 1
Apopka, FL 32703
Phone (407) 478-3202

1312 Manatee Ave E
Bradenton, FL 34208
Phone (941) 708-8700

2020 59th St W
Bradenton, FL 34209
Phone (813) 798-6303

720 SW 2nd Ave
Ste 160A
Gainesville, FL 32601
Phone (352) 240-8000

3581 SW Archer Rd
Ste 40
Gainesville, FL 32608
Phone (352) 888-4449

2323 S Orange Ave
Ste A
Orlando, FL 32806
Phone (407) 418-9999

2555 S Kirkman Rd
Orlando, FL 32811
Phone (407) 362-2030

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1508849829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 8TH AVE W STE 101",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342214737",
            "telephone_number": "941-776-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 MANATEE AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081452",
            "telephone_number": "941-747-4661",
            "fax_number": "941-746-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URRUTIA",
        "first_name": "LUIS",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0064527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023444900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278236700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.