COUNTRYSIDE MEDICAL PA
NPI 1275610362
Internal Medicine in Ocala, FL
NPI Status: Active since November 01, 2006
Contact Information
7860 SW 103RD STREET RD
BLDG 100 SUITE 101
OCALA, FL
ZIP 34476
Phone: (352) 873-4458
Fax: (352) 873-8116
- Organization
- Internal Medicine
- Accepts Insurance
- CLIA Number: 10D0942818
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 09-08-2025
About COUNTRYSIDE MEDICAL PA
This page provides the complete NPI Profile along with additional information for Countryside Medical Pa, an internist established in Ocala, Florida operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1275610362 assigned on November 2006. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Kenneth Baruch Lee Do (Owner President)
- NPI
- 1275610362
- Provider Name
- COUNTRYSIDE MEDICAL PA
- Entity Type
- Organization
- Location Address
- 7860 SW 103RD STREET RD BLDG 100 SUITE 101 OCALA, FL 34476
- Location Phone
- (352) 873-4458
- Location Fax
- (352) 873-8116
- Mailing Address
- PO BOX 770719 OCALA, FL 34477
- Mailing Phone
- (352) 873-4458
- Mailing Fax
- (352) 873-8116
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-01-2006
- Last Update Date
- 09-01-2023
- Code Navigator
An internist like Countryside Medical Pa is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, 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
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
- BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - PPO
- BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) - PPO
- BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - PPO
- BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) - PPO
- BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - PPO
- BlueOptions Silver 24J01-03 ($0 Virtual PCP Visits / $0 Labs / Rewards) - PPO
- BlueOptions Silver 24J01-07 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
- BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards) - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| CG9421 | OTHER (01) | RR MEDICARE |
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
- 10D0942818
- Facility Type
- Physician Office
- Certificate Effective Date
- September 09, 2023
- Certificate Expiration Date
- September 08, 2025
- Laboratory Director
- KENNETH B. LEE
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Countryside Medical Pa 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.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 7 | 5 | 6 | 1 | 0 | 3 | 6 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 14 | 5 | 12 | 1 | 0 | 3 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 4 + 5 + 1 + 2 + 1 + 0 + 3 + 1 + 2 + 24 = 48 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 48 = 2 | 2 | ||||||||
The NPI number 1275610362 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1598842684 | ALAN LEE MOSTOV DO Individual | Family Medicine | 7860 SW 103RD STREET RD BLDG 100 SUITE 101 OCALA, FL 34476 (352) 873-4458 |
| 1366888463 | HEIDI NICOLE ECK APRN Individual | Nurse Practitioner (Adult Health) | 7860 SW 103RD STREET RD OCALA, FL 34476 (352) 873-4458 |
| 1861960049 | LISA ANNE EGAN PT Individual | Physical Therapist | 7860 SW 103RD STREET RD OCALA, FL 34476 (352) 854-3424 |
| 1023195112 | KENNETH BARUCH LEE DO Individual | Family Medicine | 7860 SW 103RD STREET RD BLDG 100 SUITE 101 OCALA, FL 34476 (352) 873-4458 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1275610362, enumerated in the NPI registry as an "organization" on November 01, 2006
The provider is located at 7860 Sw 103rd Street Rd Bldg 100 Suite 101 Ocala, Fl 34476 and the phone number is (352) 873-4458
This medical organization specializes in Internal Medicine with taxonomy code 207R00000X
The provider might be accepting Accepts: Florida Blue (BlueCross BlueShield FL), Railroad. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 10D0942818 for a "physician office" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued 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..
This NPI record was last updated on November 01, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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