NPIMap

Individual provider Active NPI

Gerald Thomas Needham Jr., D.O.

  • Nephrology Physician
  • Clearwater, FL
National Provider Identifier
1962427195
Registry record updated Jan 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
OS7262 Issued in FL
Practice address
1305 S Fort Harrison Ave
Building H
Clearwater, FL 33756-3301
Phone
(727) 441-0104
Fax
(727) 441-8272
NPI assigned
Jul 12, 2006
Last updated
Jan 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X OS7262 FL Primary

Addresses

Primary practice location

1305 S Fort Harrison Ave
Building H
Clearwater, FL 33756-3301

Mailing address

1305 S Fort Harrison Ave
Building H
Clearwater, FL 33756-3301
Phone (727) 441-0104

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
I20040826000940 FL Practitioner - NephrologyPractitioner - Family Practice 2860467644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Mid West Medical College, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1305 S Fort Harrison Ave
H
Clearwater, FL 33756-3301
Phone (727) 441-0104

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Nephrology, PL Nephrology CurrentSince Dec 1, 2007 Accepting new patients
Da Campbell MD PA Nephrology PastSince Dec 1, 2007 Accepting new patients
Sun Coast Hospital Inc Past Accepting new patients
Largo Physician Group, LLC PastSince Nov 4, 2012 Accepting new patients

Locations

1305 S Fort Harrison Ave
Ste H
Clearwater, FL 33756
Phone (727) 441-0104

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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 6

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199577600000",
    "number": "1962427195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 S FORT HARRISON AVE",
            "address_2": "BUILDING H",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563301",
            "telephone_number": "727-441-0104",
            "fax_number": "727-441-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 S FORT HARRISON AVE",
            "address_2": "BUILDING H",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563301",
            "telephone_number": "727-441-0104",
            "fax_number": "727-441-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEEDHAM",
        "first_name": "GERALD",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "OS7262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.