Individual provider Active NPI

Robert B Wyko, DO

  • General Practice Physician
  • Dunedin, FL
National Provider Identifier
1891730685
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OS3673 Issued in FL
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

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0105064OtherFLUNITED HEALTHCARE
5352090OtherFLAETNA
593709395OtherFLTAX ID
010065622OtherFLRAILROAD MEDICARE
123317OtherFLHUMANA
021226000MedicaidFL
211531OtherFLAVMED
82091OtherFLBCBS
0100584OtherFLEVERCARE
1679215OtherFLCIGNA

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
I20100806000774 FL Practitioner - General Practice 4082686258 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS3673FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. General Practice CurrentSince Jun 12, 2017 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Jun 12, 2017 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.