Active NPI
Robert B Wyko, DO
- General Practice Physician
- Dunedin, FL
National Provider Identifier
1891730685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- OS3673
- Practice address
- 180 Patricia Ave
Dunedin, FL 34698-8103 - Phone
- (727) 733-4193
- Fax
- (813) 635-2628
- NPI assigned
- Jun 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | OS3673 | FL | Primary |
Addresses
Primary practice location
180 Patricia Ave
Dunedin, FL 34698-8103
Mailing address
2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 532-1355
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0105064 | Other | FL | UNITED HEALTHCARE |
| 5352090 | Other | FL | AETNA |
| 593709395 | Other | FL | TAX ID |
| 010065622 | Other | FL | RAILROAD MEDICARE |
| 123317 | Other | FL | HUMANA |
| 021226000 | Medicaid | FL | |
| 211531 | Other | FL | AVMED |
| 82091 | Other | FL | BCBS |
| 0100584 | Other | FL | EVERCARE |
| 1679215 | Other | FL | CIGNA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS3673 | FL | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baycare Medical Group, Inc. | General Practice | Current | Accepting new patients |
| Baycare Medical Group, Inc. | Current | Accepting new patients | |
| Optum Care Services Company | Past | 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
1022 Main St
Ste M
Dunedin, FL 34698
Phone (727) 210-2225
180 Patricia Ave
Dunedin, FL 34698
Phone (727) 733-4193
Interoperability endpoints
- robert.wyko@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.
-
- General Practice Physician
- Clearwater, FL
- NPI 1043269871
-
- Family Medicine Physician
- Clearwater, FL
- NPI 1659720837
-
- Family Nurse Practitioner
- Columbia, MD
- NPI 1912199415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728864000000",
"number": "1891730685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2995 DREW ST FL 2",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337593012",
"telephone_number": "727-532-1355",
"fax_number": "813-635-2613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 PATRICIA AVE",
"city": "DUNEDIN",
"state": "FL",
"postal_code": "346988103",
"telephone_number": "727-733-4193",
"fax_number": "813-635-2628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYKO",
"first_name": "ROBERT",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-17",
"last_updated": "2024-10-14",
"certification_date": "2024-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "OS3673",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0105064",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5352090",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "593709395",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "010065622",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "123317",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "021226000",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "211531",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "82091",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "0100584",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1679215",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dunedin, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.