Bayshore Pathology Consultants PA

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

ME70208 Issued in FL

Legal business name

BAYSHORE PATHOLOGY CONSULTANTS PA

Practice address

18338 Murdock Circle
Port Charlotte, FL 33948-1032

Phone

(941) 313-9009

Fax

(941) 623-9532

NPI assigned

Dec 6, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Virginia Oquendo

Title

Credentialing Specialist

Phone

(941) 315-9955

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners 3

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

• Carlos A Ricotti, MD

  • Dermatopathology Physician
  • Miami, FL
  • NPI 1497956569
  Medicare reassignment NPD
• Jose Augusto Ross, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Port Charlotte, FL
  • NPI 1235119124
  Medicare reassignment NPD
• Ernest Wu, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Naples, FL
  • NPI 1104890383
  Medicare reassignment NPD

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1700217460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18338 MURDOCK CIRCLE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481032",
            "telephone_number": "941-313-9009",
            "fax_number": "941-623-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18338 MURDOCK CIRCLE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481032",
            "telephone_number": "941-313-9009",
            "fax_number": "941-623-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSHORE PATHOLOGY CONSULTANTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "OQUENDO",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "941-315-9955",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME70208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110921700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "005AY",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon K Batzer, OD
• Carrie Jean Bauer, PA
• Brittany Baumhardt, LCSW
• Bay Pines Vamc
• Michael Bays, D.O.
• Gregory Dale Bazzo, DPT
• Beacon Clinic, Inc.
• Marie May Beadle, PHARMD
• Jeffrey Allen Beal, M.D.
• Meaghan Beal

• Anatomic Pathology & Clinical Pathology Physician in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.