Dynamic Primary Healthcare Clinic
NPI 1710633144 · Family Medicine Physician · Lake City, FL
Enrolled with Medicare as Part a Provider - Rural Health Clinic · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Dynamic Primary Healthcare Clinic is a Family Medicine Physician organization in Lake City, FL (NPI 1710633144).
Provider details
- NPI number
- 1710633144
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- John Distefano, Business Manager(352) 317-3214
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
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
Mailing address
Registry dates
- Enumerated
- 2022-02-24
- Last updated
- 2024-03-18
- Certified
- 2024-03-18
Frequently asked questions
- What is Dynamic Primary Healthcare Clinic's NPI number?
- Dynamic Primary Healthcare Clinic's National Provider Identifier (NPI) is 1710633144, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Dynamic Primary Healthcare Clinic?
- Dynamic Primary Healthcare Clinic is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Dynamic Primary Healthcare Clinic located?
- Dynamic Primary Healthcare Clinic's practice location on file with NPPES is 163 Sw Stonegate Ter Ste 109, Lake City, FL 32024-3459.
- What is Dynamic Primary Healthcare Clinic's phone number?
- The practice phone number listed in the NPPES registry for Dynamic Primary Healthcare Clinic is (330) 323-8976.
- Does Dynamic Primary Healthcare Clinic accept Medicare?
- Dynamic Primary Healthcare Clinic is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Dynamic Primary Healthcare Clinic?
- The authorized official listed on Dynamic Primary Healthcare Clinic's NPPES record is John Distefano, Business Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Dynamic Primary Healthcare Clinic's NPI active?
- Yes — Dynamic Primary Healthcare Clinic's NPI (1710633144) is active in the NPPES registry as of the last update on 2024-03-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.