Jeffrey Wayne Baltzer, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

ME124617 Issued in FL

Practice address

732 N 3Rd St
Leesburg, FL 34748-4442

Phone

(352) 365-4575

Fax

(352) 273-8172

NPI assigned

Feb 7, 2006

Last updated

Feb 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Clinical Practice Association Inc

  dba UF Health Physicians

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  NPD
• Florida Clinical Practice Association Inc

  dba UF Health Family Medicine Ocala Heath Brook

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD
• St Luke's Physician Group Inc

  dba St. Luke's Developmental Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1417478413
  NPD
• St Luke's Physician Group Inc

  dba St. Luke's Primary Care Orwigsburg

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD
• St. Luke's Physician Group, Inc.

  dba South Mountain Family Practice

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  NPD
• Arnot Medical Services PLLC

  • Internal Medicine Physician
  • Elmira, NY
  • NPI 1427326768
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1760454284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100275",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100275",
            "telephone_number": "352-273-7839",
            "fax_number": "352-273-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 N 3RD ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347484442",
            "telephone_number": "352-365-4575",
            "fax_number": "352-273-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTZER",
        "first_name": "JEFFREY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD028023E",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "188249-1",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME124617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01927128",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CC9269",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015363200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "220029208",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "GU039827",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017380000001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew P. Bailey, PTA
• Danielle Kesha-Lue Bailey
• Richard Louis Bailey, RPH
• Jill Baird, LCSW
• Neyton Baltodano, M.D.
• Sujata Shankarappa Balulad, M.D.
• Dwaraknadh R Banala, M.D.
• Sommer Hope Bankson, APRN
• Diane Barber
• Tiffany Barber

• Anatomic Pathology & Clinical Pathology Physician in Leesburg, FL
• Providers in Leesburg, 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 Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.