Individual provider Active NPI

Jose Manuel Canabal Montalvo, MD

  • Internal Medicine Physician
  • Clearwater, FL
National Provider Identifier
1972132496
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME168291 Issued in FL
Practice address
29750 US Highway 19 N Ste 101
Clearwater, FL 33761-1510
Phone
(727) 786-5058
Fax
(813) 635-2639
NPI assigned
Apr 6, 2020
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME168291 FL Primary
Internal Medicine Physician 207R00000X 324533 NY

Addresses

Primary practice location

29750 US Highway 19 N Ste 101
Clearwater, FL 33761-1510

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 315-7496

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jose.CanabalMontalvoMD@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

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
I20241001003633 FL Practitioner - Internal Medicine 1355705971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

29750 US Hwy 19 N
Suite 101
Clearwater, FL 33761-1510
Phone (727) 786-5058

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
324533NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Internal Medicine Current Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Jul 31, 2023 Accepting new patients
Baycare Medical Group, Inc CurrentSince Sep 16, 2024 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Sep 16, 2024 Accepting new patients
North Shore - Lij Medical PC Internal Medicine CurrentSince Jul 31, 2023 Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

29750 US Highway 19 N
Ste 101
Clearwater, FL 33761
Phone (727) 286-6203

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

Interoperability endpoints

  • Direct secure messaging: jose.canabalmontalvomd@direct.mybaycare.org

Organizations & group practices 5

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 3

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1972132496",
    "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": "727-315-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29750 US HIGHWAY 19 N STE 101",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337611510",
            "telephone_number": "727-786-5058",
            "fax_number": "813-635-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANABAL MONTALVO",
        "first_name": "JOSE",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME168291",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "324533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jose.CanabalMontalvoMD@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "29750 US Highway 19 N Ste 101",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337611510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.