TIMOTHY L. LIGHT D.O., P.A.
NPI 1306191028
Family Medicine in Clearwater, FL
About Timothy L. Light D.o., P.a. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIMOTHY L. LIGHT D.O., P.A. (NPI 1306191028) is a healthcare organization registered as a family medicine in Clearwater, Florida and active in the NPI registry since July 2012. The organization lists Timothy Lee Light, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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)
Timothy L. Light D.o., P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
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.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Timothy L. Light D.O., P.A., which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Timothy L. Light D.O., P.A.'s NPI number?
The NPI number for Timothy L. Light D.O., P.A. is 1306191028. It was assigned to this organization in the NPPES registry on July 18, 2012.
Where is Timothy L. Light D.O., P.A. located?
Timothy L. Light D.O., P.A. is located at 1573 S Fort Harrison Ave, Clearwater, FL 33756. The listed phone number is (727) 584-8777.
What is Timothy L. Light D.O., P.A.'s specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Timothy L. Light D.O., P.A. enrolled in Medicare?
Yes. Timothy L. Light D.O., P.A. is registered in the Medicare PECOS enrollment system.
When is Timothy L. Light D.O., P.A.'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 November 30, 2026. 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 Timothy L. Light D.O., P.A.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Timothy L. Light D.O., P.A.. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Timothy L. Light D.O., P.A. was last updated on July 18, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Timothy L. Light D.o., P.a. · NPI 1306191028
Family Medicine organization in Clearwater, Florida. Organization record, active in the CMS NPPES registry since July 18, 2012.
## Identity
- **NPI:** 1306191028 (Entity type: Organization)
- **Enumerated:** July 18, 2012
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Timothy Light, PRESIDENT
## Practice location
- **Address:** 1573 S FORT HARRISON AVE, Clearwater, FL 33756-2004
- **Phone:** (727) 584-8777 · **Fax:** (727) 216-6117
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Florida, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 18, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1306191028) · Data from the CMS NPPES public registry.