NPIMap

Organization Active NPI

Bay Area Gastrointestinal Endoscopy and Liver Specialists LLC

  • Specialist
  • Clearwater, FL
National Provider Identifier
1699797266
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME64901 Issued in FL
Legal business name
BAY AREA GASTROINTESTINAL ENDOSCOPY AND LIVER SPECIALISTS LLC
Practice address
1305 S Fort Harrison Ave
Suite E
Clearwater, FL 33756-3301
Phone
(727) 631-0915
Fax
(727) 631-0916
NPI assigned
Jul 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Authorized official

Name
Mr. Jody S Berner, MDNPI 1245280395
Title
President
Phone
(727) 631-0915

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME64901 FL Primary

Addresses

Primary practice location

1305 S Fort Harrison Ave
Suite E
Clearwater, FL 33756-3301

Mailing address

1305 S Fort Harrison Ave
Suite E
Clearwater, FL 33756-3301
Phone (727) 631-0915

Other identifiers 1

IdentifierTypeStateIssuer
374224500MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051107000722 FL Part B Supplier - Clinic/Group Practice 5799703831 Receives reassigned benefits from 14 practitioners
Practice locations: Clearwater, FL

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1305 S Fort Harrison Ave
Ste D
Clearwater, FL 33756
Phone (727) 441-9444

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1699797266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 S FORT HARRISON AVE",
            "address_2": "SUITE E",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563301",
            "telephone_number": "727-631-0915",
            "fax_number": "727-631-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 S FORT HARRISON AVE",
            "address_2": "SUITE E",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563301",
            "telephone_number": "727-631-0915",
            "fax_number": "727-631-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA GASTROINTESTINAL ENDOSCOPY AND LIVER SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "BERNER",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-631-0915",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME64901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374224500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.