MOBILE PHYSICIAN SERVICES INC. NPI 1003002759
Internal Medicine (Hospice and Palliative Medicine) in New Port Richey, FL
About MOBILE PHYSICIAN SERVICES INC.
Mobile Physician Services Inc. is a provider established in New Port Richey, Florida specializing in internal medicine. The NPI number of Mobile Physician Services Inc. is 1003002759 and was assigned on September 2007. The practitioner's primary taxonomy code is 207RH0002X. The provider is registered as an organization and their NPI record was last updated December 2019. Mobile Physician Services Inc. operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Dr. Richard M Wacksman M.d. (Medical Director)
The CLIA number of Mobile Physician Services Inc. is 10D2000296 registered as a "other" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Mobile Physician Services Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
| NPI | 1003002759 |
| Provider Name | MOBILE PHYSICIAN SERVICES INC. |
| Provider Location Address | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 |
| Provider Mailing Address | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Enumeration Date | 09-17-2007 |
| Last Update Date | 12-05-2019 |
Primary Taxonomy
| Taxonomy Code | 207RH0002X |
| Classification | Internal Medicine |
| Type | Allopathic & Osteopathic Physicians |
| Specialization | Hospice and Palliative Medicine |
| Taxonomy Description | An internal medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. |
Business Address
MOBILE PHYSICIAN SERVICES INC.
6804 CECELIA DR
NEW PORT RICHEY, FL
ZIP 34653
Phone: (727) 232-0644
Fax: (888) 546-0488
Mailing Address
MOBILE PHYSICIAN SERVICES INC.
6804 CECELIA DR
NEW PORT RICHEY, FL
ZIP 34653
Phone: (727) 232-0644
Fax: (888) 546-0488
Secondary Locations
Beavercreek Township, OH 45431
(855) 232-0644
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003002759 is:
| CLIA Number | 10D2000296 |
| Facility Type | OTHER |
| Certificate Type | Certificate of Waiver |
Group Taxonomy
193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 152W00000X | Eye and Vision Services Providers | Optometrist | OPC2447 | FL | No | |
Taxonomy Description: doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. | |||||||
| 2 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | ME0086161 | FL | No | |
Taxonomy Description: a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. | |||||||
| 3 | 2084P0805X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Geriatric Psychiatry | ME105037 | FL | No |
Taxonomy Description: geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. | |||||||
| 4 | 213ES0103X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery | No | ||
Taxonomy Description: | |||||||
| 5 | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | ARNP9264372 | FL | No |
Taxonomy Description: | |||||||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State |
|---|---|---|
| MEDICARE NPI | OTHER (01) | FL |
| 007870000 | MEDICAID (05) | FL |
| K9757 | OTHER (01) | FL |
| 000MQ | OTHER (01) | FL |
Other Providers at the same location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1003155110 | BILLY SHANNON CLAY FNP-BC Individual | Nurse Practitioner (Primary Care) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1033366299 | DR. RICHARD JOSEPH CAMPANILE D.O. Individual | Family Medicine | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1043284680 | DOUGLAS P. NAGLE P.A. Individual | Physician Assistant | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1083683353 | DR. JAMES K. CONDON M.D. Individual | Internal Medicine (Hospice and Palliative Medicine) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1144211061 | MR. ROBERT KLEID PA-C Individual | Physician Assistant (Medical) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1205884269 | MRS. CHRISTI GANNER GAGLIANO ARNP Individual | Nurse Practitioner (Family) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1306820394 | PAMELA LYNN JUNE PHD Individual | Psychologist (Clinical) | 6804 CECELIA DR SUITE 201 NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1336408483 | MRS. TIFFANY REICHBACH NP-C Individual | Nurse Practitioner (Adult Health) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1427149517 | JOSEPHINE F ADELUFOSI ARNP Individual | Nurse Practitioner (Adult Health) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1427418193 | ANNE MARIE THOMPSON ARNP Individual | Nurse Practitioner (Family) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1457710287 | MRS. MELISSA G COLE ARNP, NP-C Individual | Nurse Practitioner (Adult Health) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1467469338 | BETH ANN-PONTIUS MOORE ARNPC Individual | Nurse Practitioner (Family) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (855) 232-0644 |
| 1538124383 | DR. WILLIAM THEODORE TRABULSI DPM Individual | Podiatrist (Foot & Ankle Surgery) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1538552328 | MS. LISA HUDSON LYNN ARNP Individual | Nurse Practitioner | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1689748840 | MRS. RITA K. NICHOLSON ARNP Individual | Nurse Practitioner (Psychiatric/Mental Health) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1699785840 | DR. SAMUEL ANTHONY PETTINA D.O. Individual | Family Medicine | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1740613850 | VIKTORIYA RAKITA ARNP Individual | Nurse Practitioner (Adult Health) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1801137138 | MS. KATHY ANN THOMPSON ARNP-C Individual | Nurse Practitioner (Adult Health) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1831140433 | MRS. PAMELA C DAILEY ARNP Individual | Nurse Practitioner | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (727) 232-0644 |
| 1831554484 | LISA M HIESTAND ARNP Individual | Nurse Practitioner (Adult Health) | 6804 CECELIA DR NEW PORT RICHEY, FL 34653 (855) 232-0644 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.