OrganizationActive
Myrtle Ridge Primary Care, P.A
NPI 1700553633 · Case Management Agency · Lutz, FL
Myrtle Ridge Primary Care, P.A is a Case Management Agency organization in Lutz, FL (NPI 1700553633).
Provider details
- NPI number
- 1700553633
- Entity type
- Organization
- Primary specialty
- Case Management AgencyAgencies
- Organization subpart
- No
- Authorized official
- Yudaisy Mogena, Office Manager(813) 909-7102
Specialties & taxonomies
Agencies
- Community Health Clinic/Center261QC1500X
Ambulatory Health Care Facilities
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1539 Dale Mabry Hwy Ste 102
Lutz, FL 33548-3008
Phone: (813) 909-7102
Fax: (813) 909-0199
Street-level locationGet directions
Mailing address
1539 Dale Mabry Hwy Ste 102
Lutz, FL 33548-3008
Registry dates
- Enumerated
- 2021-08-27
- Last updated
- 2024-05-06
- Certified
- 2024-05-06
Frequently asked questions
- What is Myrtle Ridge Primary Care, P.A's NPI number?
- Myrtle Ridge Primary Care, P.A's National Provider Identifier (NPI) is 1700553633, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Myrtle Ridge Primary Care, P.A?
- Myrtle Ridge Primary Care, P.A is classified in the NPPES registry as Case Management Agency (Agencies).
- Where is Myrtle Ridge Primary Care, P.A located?
- Myrtle Ridge Primary Care, P.A's practice location on file with NPPES is 1539 Dale Mabry Hwy Ste 102, Lutz, FL 33548-3008.
- What is Myrtle Ridge Primary Care, P.A's phone number?
- The practice phone number listed in the NPPES registry for Myrtle Ridge Primary Care, P.A is (813) 909-7102.
- Who is the authorized official for Myrtle Ridge Primary Care, P.A?
- The authorized official listed on Myrtle Ridge Primary Care, P.A's NPPES record is Yudaisy Mogena, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Myrtle Ridge Primary Care, P.A's NPI active?
- Yes — Myrtle Ridge Primary Care, P.A's NPI (1700553633) is active in the NPPES registry as of the last update on 2024-05-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.