Individual provider Active NPI

Roland L Chin-Lue, MD

  • Gastroenterology Physician
  • Lutz, FL
National Provider Identifier
1770746190
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME101582 Issued in FL
Practice address
4211 Van Dyke Rd
#200
Lutz, FL 33558-8005
Phone
(813) 264-6490
Fax
(813) 443-8143
NPI assigned
Jul 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME101582 FL Primary

Addresses

Primary practice location

4211 Van Dyke Rd
#200
Lutz, FL 33558-8005

Mailing address

PO Box 10744
Clearwater, FL 33757-8744
Phone (727) 532-0002

Other identifiers 1

IdentifierTypeStateIssuer
001214900MedicaidFL

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
I20080903000497 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 5890861587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

4730 N Habana Ave
Suite 300
Tampa, FL 33614-7148
Phone (813) 876-0951

Hospital & facility affiliations

  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy39
Upper gastrointestinal (GI) endoscopy for acid reflux104

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince May 1, 2015 Accepting new patients
Baycare Medical Group, Inc. CurrentSince May 1, 2015 Accepting new patients
Mark T Howell DO PA PastSince Jun 26, 2012 Accepting new patients

Locations

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

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

4211 Van Dyke Rd
#200
Lutz, FL 33558
Phone (813) 264-6490

4730 N Habana Ave
Ste 300
Tampa, FL 33614
Phone (813) 352-9465

Interoperability endpoints

  • Direct secure messaging: rolandl.chin-lue@direct.mybaycare.org

Organizations & group practices 3

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1770746190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10744",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337578744",
            "telephone_number": "727-532-0002",
            "fax_number": "727-266-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 VAN DYKE RD",
            "address_2": "#200",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335588005",
            "telephone_number": "813-264-6490",
            "fax_number": "813-443-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN-LUE",
        "first_name": "ROLAND",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME101582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001214900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.