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BAYCARE MEDICAL GROUP INC
NPI 1023681558
Family Medicine in St Petersburg, FL

Active since July 22, 2021CLIA Certified · 6 labs
560 JACKSON ST N STE 302, ST PETERSBURG, FL 33705(727) 895-9640(727) 895-9692 Get Directions Write a Review

NPPES record last updated: July 22, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Baycare Medical Group Inc NPPES

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

BAYCARE MEDICAL GROUP INC (NPI 1023681558) is a healthcare organization registered as a family medicine in St Petersburg, Florida and active in the NPI registry since July 2021. The organization holds 6 active CLIA laboratory certificates and lists Lynda Gorken, Vp, as its authorized official.

NPPES Registry Identity

NPI1023681558
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBAYCARE MEDICAL GROUP INC
Location Address560 JACKSON ST N STE 302St Petersburg, FL 33705-1449
Mailing Address2995 Drew St Fl 3Clearwater, FL 33759-3012
Phone(727) 895-9640
Fax(727) 895-9692
Organization SubpartNo
Authorized OfficialLynda GorkenVp · (727) 281-9202
Enumeration DateJuly 22, 2021
NPPES CertifiedJune 24, 2021
✔ NPI 1023681558 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedInternal MedicineTaxonomy 207R00000X
560 JACKSON ST N STE 302, St Petersburg, FL 33705
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Other Names 1

Other NameJackson Street Primary Care

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 6

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 Compliance 10D0994171

Baycare Medical Group, Inc · Saint Petersburg, FL
Active · expires Dec 12, 2027
CLIA Number10D0994171
Laboratory TypePhysician Office
Certificate Effective DateDecember 13, 2025
Certificate Expiration DateDecember 12, 2027
Laboratory DirectorDr. James Connors
Laboratory Phone(727) 315-7446
Laboratory LocationBaycare Medical Group, Inc620 10th Street North 3A, Saint Petersburg, FL 33705
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 10D0992656

Baycare Medical Group Inc · Saint Petersburg, FL
Active · expires Oct 22, 2027
CLIA Number10D0992656
Laboratory TypePhysician Office
Certificate Effective DateOctober 23, 2025
Certificate Expiration DateOctober 22, 2027
Laboratory DirectorDavid E. Jones
Laboratory Phone(727) 240-0531
Laboratory LocationBaycare Medical Group Inc620 10th St N Ste 2E, Saint Petersburg, FL 33705
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D0291498

Baycare Medical Group Inc · Saint Petersburg, FL
Active · expires Jul 28, 2027
CLIA Number10D0291498
Laboratory TypePhysician Office
Certificate Effective DateJuly 29, 2025
Certificate Expiration DateJuly 28, 2027
Laboratory DirectorCharyse Sindler
Laboratory Phone(727) 240-0531
Laboratory LocationBaycare Medical Group Inc620 10th St N Ste 3E, Saint Petersburg, FL 33705
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D0292109

Baycare Medical Group Inc · Saint Petersburg, FL
Active · expires May 31, 2027
CLIA Number10D0292109
Laboratory TypePhysician Office
Certificate Effective DateJune 1, 2025
Certificate Expiration DateMay 31, 2027
Laboratory DirectorDr. Eric Diner
Laboratory Phone(727) 240-0531
Laboratory LocationBaycare Medical Group Inc620 10th St N 3D, Saint Petersburg, FL 33705
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D0952900

Baycare Medical Group Inc · Saint Petersburg, FL
Active · expires Oct 20, 2026
CLIA Number10D0952900
Laboratory TypePhysician Office
Certificate Effective DateOctober 21, 2024
Certificate Expiration DateOctober 20, 2026
Laboratory DirectorKevin F. Garner
Laboratory Phone(727) 240-0531
Laboratory LocationBaycare Medical Group Inc620 10th St N Ste 2A, Saint Petersburg, FL 33705
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D1003528

Baycare Medical Group · Saint Petersburg, FL
Active · expires Sep 3, 2026
CLIA Number10D1003528
Laboratory TypePhysician Office
Certificate Effective DateSeptember 4, 2024
Certificate Expiration DateSeptember 3, 2026
Laboratory DirectorCory Nelson
Laboratory Phone(727) 240-0531
Laboratory LocationBaycare Medical Group620 10th St N 1st Fl, Saint Petersburg, FL 33705
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BAYCARE BEHAVIORAL HEALTH INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
560 JACKSON ST N STE 302
ST PETERSBURG, FL 33705
Pinellas County (727) 820-7701
MR. SAMIR KLAPUH APRN
Nurse Practitioner (Primary Care)
560 JACKSON ST N STE 302
ST PETERSBURG, FL 33705
Pinellas County (727) 895-9640
DR. THOMAS MARVIN TRAVIS DO
Family Medicine
560 JACKSON ST N STE 302
ST PETERSBURG, FL 33705
Pinellas County (727) 849-4063
MARJORIE CAPERS LCSW
Social Worker (Clinical)
560 JACKSON ST N STE 302
ST PETERSBURG, FL 33705
Pinellas County (727) 825-1479
DR. THOMAS J ROBISON M.D.
Family Medicine
560 JACKSON ST N STE 302
SAINT PETERSBURG, FL 33705
Pinellas County (727) 895-9640
LORI ELLEN ANDREWS LMHC
Counselor (Mental Health)
560 JACKSON ST N STE 302
ST PETERSBURG, FL 33705
Pinellas County (727) 849-4063
DR. JOELLE ELLIS
Internal Medicine
560 JACKSON ST N STE 302
ST PETERSBURG, FL 33705
Pinellas County (727) 895-9640
ANGELA VU
Family Medicine
560 JACKSON ST N STE 302
SAINT PETERSBURG, FL 33705
Pinellas County (727) 532-0002

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 Baycare Medical Group Inc's NPI number?

The NPI number for Baycare Medical Group Inc is 1023681558. It was assigned to this organization in the NPPES registry on July 22, 2021. The provider is also known as Jackson Street Primary Care.

Where is Baycare Medical Group Inc located?

Baycare Medical Group Inc is located at 560 Jackson St N Ste 302, St Petersburg, FL 33705. The listed phone number is (727) 895-9640.

What is Baycare Medical Group Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Baycare Medical Group Inc hold CLIA laboratory certificates?

Yes. 6 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Baycare Medical Group Inc was last updated on July 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.