Individual provider Active NPI

David Gubernick, MD

  • Allergy & Immunology Physician
  • Largo, FL
National Provider Identifier
1609259456
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
ME141702 Issued in FL
Practice address
13145 66TH St
Largo, FL 33773-1812
Phone
(727) 530-0700
Fax
(727) 530-0777
NPI assigned
Jun 29, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME141702 FL
Pediatrics Physician 208000000X ME141702 FL
Allergy & Immunology Physician 207K00000X ME141702 FL Primary
Pediatric Allergy/Immunology Physician 2080P0201X ME141702 FL

Addresses

Primary practice location

13145 66TH St
Largo, FL 33773-1812

Mailing address

13145 66TH St
Largo, FL 33773-1812
Phone (727) 530-0700

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
I20210603000683 FL Practitioner - Allergy/Immunology 8820305188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Florida College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samuel Gubernick DO PAGroup PAC ID 6002993268, 3 clinicians

Practice addresses (Care Compare)

13145 66TH St N
Largo, FL 33773-1812
Phone (727) 530-0700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME141702FLMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel Gubernick DO PA Single Specialty CurrentSince Jul 1, 2021 Accepting new patients

Locations

13145 66th St
Largo, FL 33773
Phone (727) 530-0700

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1609259456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13145 66TH ST",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337731812",
            "telephone_number": "727-530-0700",
            "fax_number": "727-530-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13145 66TH ST",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337731812",
            "telephone_number": "727-530-0700",
            "fax_number": "727-530-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUBERNICK",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME141702",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME141702",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME141702",
            "primary": true
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "FL",
            "license": "ME141702",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.