BAYSIDE URGENT CARE CENTER INC. – Urgent Care Clinic/Center, NPI 1619257755

BAYSIDE URGENT CARE CENTER INC. is a healthcare provider. based in Tampa, Florida. specializing in Urgent Care Clinic/Center. The organization holds a License No. BTR-0029514 (FL). The NPI Number for BAYSIDE URGENT CARE CENTER INC. is 1619257755

Main info

Organization
Name
BAYSIDE URGENT CARE CENTER INC.
NPI
1619257755
Phone
(813) 508-2225
Address
10030 NEW PARKE RD
Authorized Official
DR. RICHARD PETERKIN WALLACE PRESIDENT/CEO MD
Enumeration Date
21 August 2011
Last Update Date
21 August 2011
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for BAYSIDE URGENT CARE CENTER INC.

  • 10030 NEW PARKE RD

    TAMPA, FL 336265414

    Phone: (813) 508-2225

    Fax: (813) 920-4999

    Type: Mailing

  • 1001 S FORT HARRISON AVE

    SUITE 101

    CLEARWATER, FL 337563905

    Phone: (813) 508-2225

    Fax: (813) 920-4999

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-02-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-10-31 (950 days ago).

Enrollment records

1

Earliest due date

2023-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20120207000314OClinic/Group PracticeFL2023-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33626)

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Reviews

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Frequently asked questions

What identifier follows BAYSIDE URGENT CARE CENTER INC. across health systems?
The NPI 1619257755 uniquely identifies BAYSIDE URGENT CARE CENTER INC. in U.S. healthcare data.
Does the public listing show BAYSIDE URGENT CARE CENTER INC. as active?
BAYSIDE URGENT CARE CENTER INC.'s NPI record reflects an active status in NPPES.
Which specialty label fits BAYSIDE URGENT CARE CENTER INC.?
NPPES ties BAYSIDE URGENT CARE CENTER INC. to Urgent Care Clinic/Center in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit BAYSIDE URGENT CARE CENTER INC. in Tampa, Florida?
For routing, start with Tampa, Florida for BAYSIDE URGENT CARE CENTER INC., then verify phone and hours locally.
Why is information missing for BAYSIDE URGENT CARE CENTER INC.?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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