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MOBILE PHYSICIAN SERVICES INC.
NPI 1003002759
Internal Medicine in New Port Richey, FL

Active since September 17, 2007CLIA 10D2000296 · Waiver
6804 CECELIA DR, NEW PORT RICHEY, FL 34653(727) 232-0644(888) 546-0488 Get Directions Write a Review

NPPES record last updated: May 28, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 28, 2026, Mar 23, 2026, Feb 18, 2021 and 3 more (6 updates tracked since 2016).

About Mobile Physician Services Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOBILE PHYSICIAN SERVICES INC. (NPI 1003002759) is a healthcare organization registered as an internal medicine in New Port Richey, Florida and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through November 24, 2027, maintains a secondary practice location in Beavercreek Township, and lists Peter Radice, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1003002759
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMOBILE PHYSICIAN SERVICES INC.
Location Address6804 CECELIA DRNew Port Richey, FL 34653-4935
Mailing Address6804 Cecelia DrNew Port Richey, FL 34653-4935 · (855) 232-0644 · Fax (888) 546-0488
Phone(727) 232-0644
Fax(888) 546-0488
Organization SubpartNo
Authorized OfficialPeter RadiceMedical Director · (855) 232-0644
Enumeration DateSeptember 17, 2007
Last NPPES UpdateMay 28, 20266 updates tracked since enumeration
NPPES CertifiedMay 28, 2026
✔ NPI 1003002759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME0086161
Definition
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.
Also ListedOptometristTaxonomy 152W00000X
Also ListedGeneral PracticeTaxonomy 208D00000X
Also ListedPodiatrist · Primary Podiatric MedicineTaxonomy 213EP1101X
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
6804 CECELIA DR, New Port Richey, FL 34653
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Secondary Practice Location 1

Location 14031 Colonel Glenn Hwy Ste 133Beavercreek Township, OH 45431-2774 · Phone (855) 232-0644 · Fax (888) 546-0488

Other Identifiers 7

Medicaid128679200FL
OtherK9757FL · Ptan
Medicaid0404354OH
OtherK9757AFL · Fl Ptan
Other000MQFL · Bcbs Group
Medicaid131106800FL
OtherMEDICARE NPIFL · 1003002759

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mobile Physician Services Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateFloridaEnrollment IDO20060505000660Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

38

Medicare enrollment records show 38 clinicians reassign Medicare billing to Mobile Physician Services Inc., which bills Medicare for the services they deliver. Of these, 29 practice at this address. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 8

Nurse Practitioner24
Family Practice5
Internal Medicine3
Podiatry2
General Practice1
Hospice/Palliative Care1
Optometry1
Psychiatry1

Nearest to this location (20)

See all 38
Darla Broderick-Breit, DO
Family Practice
NPI 1538133327
6804 CECELIA DRIVE
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Laura Cannon, FNP-C
Nurse Practitioner
NPI 1235634221
6804 CECELIA DR
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Christi Gagliano, APRN
Nurse Practitioner
NPI 1205884269
6804 CECELIA DR
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Heather Goldner, DNP, FNP-C
Nurse Practitioner
NPI 1801229554
6804 CECELIA DR
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Kelli Horstman
Nurse Practitioner
NPI 1003573072
6804 CECELIA DR
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Ruth Lambe
Nurse Practitioner
NPI 1801471602
6804 CECELIA DR
New Port Richey, FL 34653
(727) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Ofelia Lopez, M.D.
General Practice
NPI 1679984561
6804 CECELIA DR
New Port Richey, FL 34653
(727) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Barry Nash, MD
Internal Medicine
NPI 1659497303
6804 CECELIA DR
New Port Richey, FL 34653
(727) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Peter Radice, M.D.
Internal Medicine
NPI 1356339170
6804 CECELIA DR
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Carly Schroeder, APRN
Nurse Practitioner
NPI 1114760121
6804 CECELIA DR
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Latoya Sinclair
Nurse Practitioner
NPI 1023616778
6804 CECELIA DR
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Adriana Smith, ARNP
Nurse Practitioner
NPI 1528561081
6804 CECELIA DR
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Johnny Tran, APRN, PMHNP-BC
Nurse Practitioner
NPI 1144937343
6804 CECELIA DRIVE
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Jasmine Wilcox, APRN
Nurse Practitioner
NPI 1346991478
6804 CECELIA DR
New Port Richey, FL 34653
(727) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Fernando Barja, O.D.
Optometry
NPI 1730521840
6804 CECELIA DR
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Cheryl Bonacquisti, ARNP-BC
Nurse Practitioner
NPI 1114450483
6804 CECELIA DRIVE
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Charles Suggs, MD
Hospice/Palliative Care
NPI 1497710172
6804 CECELIA DR
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
William Trabulsi, DPM
Podiatry
NPI 1538124383
6804 CECELIA DR
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Junell Koberlein, MD
Family Practice
NPI 1982868865
6804 CECELIA DRIVE
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
Heather Bruneau, M.D., MPH
Internal Medicine
NPI 1376770727
6804 CECELIA DRIVE
New Port Richey, FL 34653
(855) 232-0644
✔ PECOS✔ Accepts MedicareSame address
See all 38 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2000296

Mobile Physician Services Inc · New Port Richey, FL
Active · expires Nov 24, 2027
CLIA Number10D2000296
Laboratory TypeMobile Physician Practice
Certificate Effective DateNovember 25, 2025
Certificate Expiration DateNovember 24, 2027
Laboratory DirectorRichard M. Wacksman
Laboratory Phone(727) 232-0644
Laboratory LocationMobile Physician Services Inc6804 Cecelia Dr, New Port Richey, FL 34653
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mobile Physician Services Inc.'s NPI number?

The NPI number for Mobile Physician Services Inc. is 1003002759. It was assigned to this organization in the NPPES registry on September 17, 2007.

Where is Mobile Physician Services Inc. located?

Mobile Physician Services Inc. is located at 6804 Cecelia Dr, New Port Richey, FL 34653. The listed phone number is (727) 232-0644.

What is Mobile Physician Services Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mobile Physician Services Inc. enrolled in Medicare?

Yes. Mobile Physician Services Inc. is registered in the Medicare PECOS enrollment system.

When is Mobile Physician Services Inc.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Mobile Physician Services Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 38 clinicians in 8 Medicare specialties reassign their Medicare billing to Mobile Physician Services Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (24), Family Practice (5) and Internal Medicine (3). Of these, 29 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Mobile Physician Services Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2000296) is associated with this NPI, valid through November 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mobile Physician Services Inc. was last updated on May 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.