MOBILE PHYSICIAN SERVICES INC. (NPI# 1003002759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003002759 |
| Entity Type | Organization |
| Organization Name | MOBILE PHYSICIAN SERVICES INC. |
| Practice Address |
6804 Cecelia Dr New Port Richey FL 34653-4935 |
| Practice Telephone | 7272320644 |
| Practice Fax Number | 8885460488 |
| Mailing Telephone | 7272320644 |
| Mailing Fax Number | 8885460488 |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2019-12-05 |
| Authorized Official Name | DR. RICHARD M WACKSMAN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8552320644 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | OPC2447 | FL | Eye and Vision Services Providers |
| N | 207R00000X | Internal Medicine | ME0086161 | FL | Allopathic & Osteopathic Physicians |
| N | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
ME105037 | FL | Allopathic & Osteopathic Physicians |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers | ||
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
ARNP9264372 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207RH0002X |
Internal Medicine Specialization: Hospice and Palliative Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 1003002759 | MEDICARE NPI | 01 |
| FL | 007870000 | 05 | |
| FL | PTAN | K9757 | 01 |
| FL | BCBS GROUP | 000MQ | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4031 Colonel Glenn Hwy Ste 133, Beavercreek Township, OH 454312774 | 8552320644 | 8885460488 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861056921 | Mobile Physician Services Inc. | Clinic/Center | 4031 Colonel Glenn Hwy Ste 133, Beavercreek Township, OH 45431-2774 | 2019-04-24 |
| Street Address |
6804 CECELIA DR |
| City | NEW PORT RICHEY |
| State | FL |
| Zip Code | 34653-4935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356339170 | Peter Arthur Radice | Internal Medicine | 6804 Cecelia Dr, New Port Richey, FL 34653-4935 | 2005-10-06 |
| 1255990693 | Jonathan Thomas Dismuke | Nurse Practitioner | 6804 Cecelia Dr, New Port Richey, FL 34653-4935 | 2019-06-10 |
| 1558845594 | Scott Wilson | Nurse Practitioner | 6804 Cecelia Dr, New Port Richey, FL 34653-4935 | 2018-09-15 |
| 1538665310 | Jennifer Danielle Quinn | Nurse Practitioner | 6804 Cecelia Dr, New Port Richey, FL 34653 | 2018-04-02 |
| 1528561081 | Adriana Smith | Nurse Practitioner | 6804 Cecelia Dr, New Port Richey, FL 34653-4935 | 2018-03-12 |
| 1114450483 | Cheryl Lynn Izzo | Nurse Practitioner | 6804 Cecelia Dr, New Port Richey, FL 34653-4935 | 2017-04-04 |
| 1427418193 | Anne Marie Thompson | Nurse Practitioner | 6804 Cecelia Dr, New Port Richey, FL 34653-4935 | 2016-02-24 |
| 1457710287 | Melissa G Cole | Nurse Practitioner | 6804 Cecelia Dr, New Port Richey, FL 34653-4935 | 2016-02-22 |
| 1831554484 | Lisa M Hiestand | Nurse Practitioner | 6804 Cecelia Dr, New Port Richey, FL 34653-4935 | 2015-12-28 |
| 1538552328 | Lisa Hudson Lynn | Nurse Practitioner | 6804 Cecelia Dr, New Port Richey, FL 34653-4935 | 2015-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669956033 | All Best Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 7114 Congress Street, New Port Richey, FL 34653 | 2018-09-20 |
| 1851880132 | Select Medical Solutions LLC | Durable Medical Equipment & Medical Supplies | 4575 Whitton Way, Unit# 1119, New Port Richey, FL 34653 | 2018-05-02 |
| 1477050151 | A & B of Pasco, Inc | Non-emergency Medical Transport (VAN) | 6449 Sutters Mill Rd, New Port Richey, FL 34653 | 2018-04-10 |
| 1841704988 | Kelly R Stryjewski | Nurse Practitioner | 6331 State Rd 54, New Port Richey, FL 34653 | 2017-11-28 |
| 1568974921 | Life Back, LLC. | Durable Medical Equipment & Medical Supplies | 8018 Old County Road 54, New Port Richey, FL 34653 | 2017-10-25 |
| 1477002558 | Amy Rebecca Patten | Nurse Practitioner | Gulfside Hospice, 6117 Trouble Creek Road, New Port Richey, FL 34653 | 2016-09-29 |
| 1972976900 | Steven Cheung | Physical Therapist | 5138 Deer Park Drive, New Port Richey, FL 34653 | 2015-11-13 |
| 1164804852 | Drew Finnegan | Chiropractor | 7653 Cypress Trace Ct, New Port Richey, FL 34653 | 2015-06-18 |
| 1699155184 | Chad Exceen | Counselor | 8002 King Helie Blvd., Baycare Behavioral Health, New Port Richey, FL 34653 | 2015-06-01 |
| 1881025005 | Elm Tree Lodge | Preferred Provider Organization | 6205 Viola Lane, New Port Richey, FL 34653 | 2013-12-13 |
| Find all providers in zip 34653 | ||||
| Taxonomy Code | 207RH0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hospice and Palliative Medicine |
| An internal medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. |
| Notes: Source: American Academy of Hospice and Palliative Medicine, www.aahpm.org [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952367047 | Clifford D. Colin | Internal Medicine | 6117 Trouble Creek Rd, New Port Richey, FL 34653-5240 | 2006-04-26 |
| 1356339170 | Peter Arthur Radice | Internal Medicine | 6804 Cecelia Dr, New Port Richey, FL 34653-4935 | 2005-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679195028 | Mid-south Home Care Services, LLC | Internal Medicine | 4776 New Broad St Ste 150, Orlando, FL 32814-6407 | 2020-05-08 |
| 1174156210 | Mid-south Home Care Services, LLC | Internal Medicine | 6161 Blue Lagoon Dr Ste 170&200, Miami, FL 33126-2057 | 2020-02-18 |
| 1003464561 | Matrix Md Corp | Internal Medicine | 987 Sw 37th Ave Apt 1011, Miami, FL 33135-4294 | 2019-08-28 |
| 1306351275 | Mid-south Home Care Services, LLC | Internal Medicine | 5111 N 12th Ave Ste B, Pensacola, FL 32504-8918 | 2017-12-13 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1730509670 | Jessica Elisabeth Eichler | Internal Medicine | 277 Nw 12th St, Boca Raton, FL 33432-2655 | 2014-04-18 |
| 1508284969 | Alison Jane Burt | Internal Medicine | 12901 Bruce B Downs Blvd # 19, Tampa, FL 33612 | 2014-04-02 |
| 1487076451 | Horizon Palliative Care Partners | Internal Medicine | 1961 Iowa Ave Ne, St Petersburg, FL 33703-3425 | 2014-01-10 |
| 1366712812 | Avow Care Services Incorporated | Internal Medicine | 1205 Whippoorwill Ln, Naples, FL 34105-5028 | 2011-12-30 |
| 1982998779 | Brittney Lee Katsoff | Internal Medicine | 5430 Nw33rd Avenue, Suite 106, Fort Lauderdale, FL 33309 | 2011-06-08 |
| Find all providers with the same taxonomy | ||||
| City | NEW PORT RICHEY |
| Zip Code | 34653 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.