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BAYCARE MEDICAL GROUP INC
NPI 1316517113
Family Medicine in St Petersburg, FL

Active since June 25, 2021CLIA 10D1061427 · Waiver
5405 PARK ST N, ST PETERSBURG, FL 33709(727) 547-8425(813) 635-2699 Get Directions Write a Review

NPPES record last updated: June 25, 2021. Verified against the NPPES registry weekly; last sync: August 16, 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 1316517113) 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 November 16, 2026 and lists Lynda Gorken, Vp, Pfs, as its authorized official.

NPPES Registry Identity

NPI1316517113
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBAYCARE MEDICAL GROUP INC
Location Address5405 PARK ST NSt Petersburg, FL 33709-1044
Mailing Address2995 Drew St Fl 3Clearwater, FL 33759-3012
Phone(727) 547-8425
Fax(813) 635-2699
Organization SubpartNo
Authorized OfficialLynda GorkenVp, Pfs · (727) 281-9202
Enumeration DateJune 25, 2021
NPPES CertifiedJune 25, 2021
✔ NPI 1316517113 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
5405 PARK ST N, St Petersburg, FL 33709
Open in Google Maps ↗

Other Names 1

Other NamePark Street Family 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 10D1061427

Baycare Medical Group Inc · Seminole, FL
Active · expires Nov 16, 2026
CLIA Number10D1061427
Laboratory TypePhysician Office
Certificate Effective DateNovember 17, 2024
Certificate Expiration DateNovember 16, 2026
Laboratory DirectorJennifer Chambers
Laboratory Phone(727) 547-8425
Laboratory LocationBaycare Medical Group Inc10799 Park Blvd, Seminole, FL 33772
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

JENNIFER REBECCA CHAMBERS D.O.
Family Medicine
5405 PARK ST N
ST PETERSBURG, FL 33709
Pinellas County (727) 547-8425
JOSHUA BOBET MD
Internal Medicine
5405 PARK ST N
ST PETERSBURG, FL 33709
Pinellas County (727) 547-8425
BLOSSOM MEDICAL CENTER CORP
Clinic/Center (Primary Care)
5405 PARK ST N
SAINT PETERSBURG, FL 33709
Pinellas County (813) 701-4909
DR. ALYSSA RAE PUTZEL APRN
Nurse Practitioner (Family)
5405 PARK ST N
SAINT PETERSBURG, FL 33709
Pinellas County (727) 547-8425
HEIDI LAI DO
Family Medicine
5405 PARK ST N
ST PETERSBURG, FL 33709
Pinellas County (727) 547-8425

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 1316517113. It was assigned to this organization in the NPPES registry on June 25, 2021. The provider is also known as Park Street Family Care.

Where is Baycare Medical Group Inc located?

Baycare Medical Group Inc is located at 5405 Park St N, St Petersburg, FL 33709. The listed phone number is (727) 547-8425.

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 10D1061427) is associated with this NPI, valid through November 16, 2026. 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.