Organization Active NPI

Roderick M Urbaniak, M.D., P.a.

  • Plastic Surgery Physician
  • Clearwater, FL
National Provider Identifier
1942640719
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
4301083724 Issued in MI
Legal business name
RODERICK M URBANIAK, M.D., P.A.
Practice address
609 Lakeview Rd
Clearwater, FL 33756-3335
Phone
(727) 447-4536
Fax
(727) 442-1600
NPI assigned
Jun 26, 2013
Last updated
Jun 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Authorized official

Name
Ms. Ginger Lynn Wiersma, 6162184495
Title
Office Manager
Phone
(616) 218-4495

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 4301083724 MI Primary

Addresses

Primary practice location

609 Lakeview Rd
Clearwater, FL 33756-3335

Mailing address

609 Lakeview Rd
Clearwater, FL 33756-3335
Phone (727) 447-4536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130722000245 FL Part B Supplier - Clinic/Group Practice 6507007366 Receives reassigned benefits from 4 practitioners
Practice locations: Largo, FL

National Provider Directory

National Provider Directory

Locations

13201 Walsingham Rd
Ste 200
Largo, FL 33774
Phone (727) 261-1754

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372204800000",
    "number": "1942640719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 LAKEVIEW RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563335",
            "telephone_number": "727-447-4536",
            "fax_number": "727-442-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 LAKEVIEW RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563335",
            "telephone_number": "727-447-4536",
            "fax_number": "727-442-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODERICK M URBANIAK, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A",
        "authorized_official_last_name": "WIERSMA",
        "authorized_official_first_name": "GINGER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "616-218-4495",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "6162184495"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301083724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.