INTERCOASTAL MEDICAL GROUP INC
NPI 1306516208
Family Medicine in Bradenton, FL

NPI Status: Active since September 14, 2021

Contact Information

11715 RANGELAND PKWY
BRADENTON, FL
ZIP 34211
Phone: (941) 538-0001

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Insurance Plans Accepted
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Family Medicine
Accepts Insurance
CLIA Number: 10D2108080
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 11-01-2026

About INTERCOASTAL MEDICAL GROUP INC

This page provides the complete NPI Profile along with additional information for Intercoastal Medical Group Inc, a primary care provider established in Bradenton, Florida operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1306516208 assigned on September 2021. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated April 2026. Intercoastal Medical Group Inc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mark J Ramos (President)

NPI: 1306516208
Provider Name: INTERCOASTAL MEDICAL GROUP INC
Entity Type: Organization
Location Address: 11715 RANGELAND PKWY BRADENTON, FL 34211
Location Phone: (941) 538-0001
Mailing Address: 943 S BENEVA RD STE 306 SARASOTA, FL 34232
Mailing Phone: (941) 955-1108
Mailing Fax
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 09-14-2021
Last Update Date: 04-08-2026
Code Navigator

A primary care provider (PCP) like Intercoastal Medical Group Inc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Family Medicine
Taxonomy Code: 207Q00000X
Type: Allopathic & Osteopathic Physicians
Taxonomy Description: 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.

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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Florida Blue (BlueCross BlueShield FL)

BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
BlueOptions Bronze 24J01-06 (Rewards) - PPO
BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO
BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - PPO
BlueOptions Silver 24J01-03 ($10 Labs / Rewards) - PPO
BlueOptions Silver 24J01-07 ($50 PCP Visits / Rewards) - PPO
BlueOptions Silver 24J01-19S ($40 PCP Visits / $80 Specialist Visits / Rewards) - PPO

Florida Blue HMO (a BlueCross BlueShield FL company)

BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
BlueCare Bronze 24K01-05 (Rewards) - POS
BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards) - POS
BlueCare Bronze 24K02-17 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
BlueCare Bronze 24K02-18 (Rewards) - POS
BlueCare Bronze 24K02-23 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
BlueCare Bronze 24K02-26S ($50 PCP Visits / Rewards) - POS
BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
BlueCare Gold 24K01-10 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - POS
BlueCare Gold 24K01-33S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
BlueCare Gold 24K02-20 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
BlueCare Gold 24K02-28S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
BlueCare Platinum 24K01-04 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - POS
BlueCare Platinum 24K01-07 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
BlueCare Platinum 24K02-15 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
BlueCare Silver 24K01-02 ($10 Labs / Rewards) - POS

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: MARK J RAMOS
Authorized Official Title: PRESIDENT
Authorized Official Phone: (941) 955-1108

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 this NPI number is:

CLIA Number: 10D2108080
Facility Type: Physician Office
Certificate Effective Date: November 02, 2024
Certificate Expiration Date: November 01, 2026
Laboratory Director: TIMOTHY D. JOHNSON
Certificate Type: Certificate of Accreditation
Certificate Type Description: This is a CLIA certificate is issued to Intercoastal Medical Group Inc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1306516208, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 42. The final step is to find the difference between that total and the next multiple of ten (50 - 42 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 0

Pos 4

Unchanged

Pos 5

Doubled → 10 → 1 + 0

Pos 6

Unchanged

Pos 7

Doubled → 12 → 1 + 2

Pos 8

Unchanged

Pos 9

Doubled → 0

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 5 → 10 → 1 6 → 12 → 3 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 0 + 6 + 1 + 0 + 1 + 1 + 2 + 2 + 0 + 24 = 42

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 42 is 50. The difference is the calculated check digit.

50 - 42 = 8

This NPI is valid

The calculated check digit is 8, which matches the last digit of 1306516208.