Individual provider Active NPI

Lolita Ontiveros, MD

  • Family Medicine Physician
  • Palm Harbor, FL
National Provider Identifier
1689087082
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME130099 Issued in FL
Practice address
3890 Tampa Rd Ste 102
Palm Harbor, FL 34684-3677
Phone
(727) 781-3150
Fax
(813) 635-2636
NPI assigned
Jun 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 125-064436 IL
Family Medicine Physician 207Q00000X ME130099 FL Primary

Addresses

Primary practice location

3890 Tampa Rd Ste 102
Palm Harbor, FL 34684-3677

Mailing address

3890 Tampa Rd Ste 102
Palm Harbor, FL 34684-3677
Phone (727) 781-3150

Other practice location 1

8787 Bryan Dairy Rd Ste 250
Largo, FL 33777-1259
Phone (727) 391-6296

Other identifiers 1

IdentifierTypeStateIssuer
022951700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Lolita.Ontiveros@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

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
I20171227000806 FL Practitioner - Family Practice 5193044972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

Hospital & facility affiliations

  • Baycare Home Care Inc Home health agency, Dunedin, FL, CCN 107415
  • Enhabit Home Health Home health agency, Clearwater, FL, CCN 109687
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127
  • Mease Countryside Hospital Hospital, Safety Harbor, FL, CCN 100265
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • Mease Dunedin Hospital Hospital, Dunedin, FL, CCN 100043

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-064436ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Dec 1, 2017 Accepting new patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Dec 1, 2017 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

3890 Tampa Rd
Ste 102
Palm Harbor, FL 34684
Phone (727) 781-3150

8787 Bryan Dairy Rd
Ste 250
Seminole, FL 33777
Phone (727) 391-6296

Interoperability endpoints

  • Direct secure messaging: lolita.ontiveros@direct.mybaycare.org

Organizations & group practices 2

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 7

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": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1689087082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 TAMPA RD STE 102",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843677",
            "telephone_number": "727-781-3150",
            "fax_number": "813-635-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 TAMPA RD STE 102",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843677",
            "telephone_number": "727-781-3150",
            "fax_number": "813-635-2636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8787 Bryan Dairy Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "337771259",
            "country_code": "US",
            "telephone_number": "727-391-6296",
            "fax_number": "813-635-7940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONTIVEROS",
        "first_name": "LOLITA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125-064436",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME130099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022951700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lolita.Ontiveros@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew St Fl 2",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337593012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.