NPIMap

Organization Active NPI

Advanced Urology Institute LLC

  • Durable Medical Equipment & Medical Supplies
  • Leesburg, FL
National Provider Identifier
1528778149
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ADVANCED UROLOGY INSTITUTE LLC
Practice address
210 S Lake St Ste 9
Leesburg, FL 34748-7369
Phone
(352) 787-4567
NPI assigned
Dec 5, 2022
Last updated
Apr 2, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANCED UROLOGY INSTITUTE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Richard Wooten
Title
Ceo
Phone
(919) 397-8768

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Urology Physician 208800000X

Addresses

Primary practice location

210 S Lake St Ste 9
Leesburg, FL 34748-7369

Mailing address

210 S Lake St Ste 9
Leesburg, FL 34748-7369
Phone (352) 787-4567

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230224000267 FL DME Supplier - Physician - Urology 2163653585 Practice locations: Leesburg, FL

Other NPIs with the same Medicare PAC ID 22

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

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Advanced Urology Insitute31 organizations share this tax ID, including this one
Part of
Advanced Urology Insitute

Other organizations with this tax ID 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1528778149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S LAKE ST STE 9",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487369",
            "telephone_number": "352-787-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S LAKE ST STE 9",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487369",
            "telephone_number": "352-787-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED UROLOGY INSTITUTE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED UROLOGY INSTITUTE LLC",
        "enumeration_date": "2022-12-05",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "WOOTEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-397-8768"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.