Individual provider Active NPI

Jeffrey William Barzyk, D.M.D.

  • Periodontics
  • Clearwater, FL
National Provider Identifier
1578786794
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN16276 Issued in FL
Practice address
2045 Gulf to Bay Blvd Ste B
Clearwater, FL 33765-3752
Phone
(727) 474-0211
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 10536 NC
Periodontics 1223P0300X DN16276 FL Primary

Addresses

Primary practice location

2045 Gulf to Bay Blvd Ste B
Clearwater, FL 33765-3752

Mailing address

2045 Gulf to Bay Blvd Ste B
Clearwater, FL 33765-3752
Phone (727) 474-0211

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160422000515 FL Order and Referring Only - DentistPractitioner - Oral SurgeryPractitioner - Dentist 2365741501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10536NCMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1578786794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 GULF TO BAY BLVD STE B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653752",
            "telephone_number": "727-474-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 GULF TO BAY BLVD STE B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653752",
            "telephone_number": "727-474-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARZYK",
        "first_name": "JEFFREY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "10536",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN16276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.