NPIMap

Individual provider Active NPI

Kevin Benjamine McBride, M.D.

  • Family Medicine Physician
  • Starke, FL
National Provider Identifier
1790791721
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME73051 Issued in FL
Practice address
1550 S Water St
Starke, FL 32091-4511
Phone
(904) 368-2480
Fax
(904) 368-2481
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME73051 FL Primary

Addresses

Primary practice location

1550 S Water St
Starke, FL 32091-4511

Mailing address

PO Box 100371
Gainesville, FL 32610-0371
Phone (352) 338-2195

Other identifiers 1

IdentifierTypeStateIssuer
254563200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040506000780 FL Practitioner - Family Practice 3678562675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Hahnemann University College of Medicine, 1992
Medicare assignment
May accept Medicare assignment
Group practices
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

PO Box
Suite 1099
Melrose, FL 32666-1099

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME73051FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc Family Medicine CurrentSince May 1, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince May 1, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Advanced Care Hospitalists PL Past Accepting new patients
Shands Teaching Hospital and Clinics Inc Past Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1550 S Water St
Fl Pa
Starke, FL 32091
Phone (904) 964-3100

922 E Call St
Starke, FL 32091
Phone (904) 368-2300

1550 S Water St
Starke, FL 32091
Phone (904) 368-2343

Interoperability endpoints

  • Direct secure messaging: kmcbride463266@direct.shands.ufl.edu

Organizations & group practices 6

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.

Hospital & facility affiliations 11

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790791721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100371",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100371",
            "telephone_number": "352-338-2195",
            "fax_number": "352-265-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S WATER ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320914511",
            "telephone_number": "904-368-2480",
            "fax_number": "904-368-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "KEVIN",
        "middle_name": "BENJAMINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME73051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254563200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Starke, FL

Sources for this page

Verify at the official NPI Registry.