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BAYCARE MEDICAL GROUP INC
NPI 1114597911
Family Medicine in St Petersburg, FL

Active since June 25, 2021CLIA 10D2001966 · Waiver
630 PASADENA AVE S, ST PETERSBURG, FL 33707(727) 360-1784(727) 360-1823 Get Directions Write a Review

NPPES record last updated: June 25, 2021. Verified against the NPPES registry weekly; last sync: August 09, 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 1114597911) is a healthcare organization registered as a family medicine in St Petersburg, Florida and active in the NPI registry since June 2021. The organization holds a CLIA Waiver certificate valid through January 4, 2028 and lists Lynda Gorken, Vp, as its authorized official.

NPPES Registry Identity

NPI1114597911
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBAYCARE MEDICAL GROUP INC
Location Address630 PASADENA AVE SSt Petersburg, FL 33707-2128
Mailing Address2995 Drew St Fl 3Clearwater, FL 33759-3012
Phone(727) 360-1784
Fax(727) 360-1823
Organization SubpartNo
Authorized OfficialLynda GorkenVp · (727) 281-9202
Enumeration DateJune 25, 2021
NPPES CertifiedJune 25, 2021
✔ NPI 1114597911 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
630 PASADENA AVE S, St Petersburg, FL 33707
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Other Names 1

Other NamePasadena 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

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 10D2001966

Baycare Medical Group Inc · South Pasadena, FL
Active · expires Jan 4, 2028
CLIA Number10D2001966
Laboratory TypePhysician Office
Certificate Effective DateJanuary 5, 2026
Certificate Expiration DateJanuary 4, 2028
Laboratory DirectorThomas Esposito
Laboratory Phone(727) 561-2450
Laboratory LocationBaycare Medical Group Inc630 Pasadena Ave S, South Pasadena, FL 33707
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 15

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

MS. HELEN FEATHERSTON ARNP
Nurse Practitioner (Family)
630 PASADENA AVE S
ST PETERSBURG, FL 33707
Pinellas County (727) 345-7100
JAN S HUMPHREYS ARNP-C
Nurse Practitioner (Adult Health)
630 PASADENA AVE S
ST PETERSBURG, FL 33707
Pinellas County (727) 345-7100
JUAN PEREIRA DO
Internal Medicine
630 PASADENA AVE S
ST PETERSBURG, FL 33707
Pinellas County (727) 360-1784
JOANN M CORREIRA ARNP
Nurse Practitioner
630 PASADENA AVE S
ST PETERSBURG, FL 33707
Pinellas County (727) 360-1784
PASADENA FAMILY MEDICAL ASSOCIATES
Family Medicine
630 PASADENA AVE S
ST PETERSBURG, FL 33707
Pinellas County (727) 345-7100
LAURA MCLEAN
Internal Medicine
630 PASADENA AVE S
SAINT PETERSBURG, FL 33707
Pinellas County (727) 360-1784
MRS. BONNIE LYNN DAVIS ARNP, BC
Nurse Practitioner (Family)
630 PASADENA AVE S
SAINT PETERSBURG, FL 33707
Pinellas County (727) 360-1784
EDWARD JOHN HILT MD
Family Medicine
630 PASADENA AVE S
ST PETERSBURG, FL 33707
Pinellas County (727) 360-1784

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 1114597911. It was assigned to this organization in the NPPES registry on June 25, 2021. The provider is also known as Pasadena Primary Care.

Where is Baycare Medical Group Inc located?

Baycare Medical Group Inc is located at 630 Pasadena Ave S, St Petersburg, FL 33707. The listed phone number is (727) 360-1784.

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 a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2001966) is associated with this NPI, valid through January 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Baycare Medical Group Inc was last updated on June 25, 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.