Charles Moore Boothby, DO is a medicare enrolled "Preventive Medicine - Undersea And Hyperbaric Medicine" physician in Palm Harbor, Florida. His current practice location is
3890 Tampa Rd, Suite 201, Palm Harbor, Florida. You can reach out to his office (for appointments etc.) via phone at
(727) 781-3111.
Charles Moore Boothby is licensed to practice in Florida (license number OS4598) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1588600092.
Physician's Profile
| Full Name | Charles Moore Boothby |
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| Gender | Male |
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| Speciality | Preventive Medicine - Undersea And Hyperbaric Medicine |
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| Location | 3890 Tampa Rd, Palm Harbor, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1588600092
- Provider Enumeration Date: 06/22/2006
- Last Update Date: 03/29/2016
Medicare PECOS Information:
- PECOS PAC ID: 4688692494
- Enrollment ID: I20051110000425
Medical Identifiers
Medical identifiers for Charles Moore Boothby such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1588600092 | NPI | - | NPPES |
| 069165800 | Medicaid | FL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | OS4598 (Florida) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Charles Moore Boothby allows following entities to bill medicare on his behalf.
| Entity Name | Nautilus Health Care Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1912013558
PECOS PAC ID: 5991604852
Enrollment ID: O20040108000803 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charles Moore Boothby is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Charles Moore Boothby, DO
Po Box 25513,
Tampa, FL 33622-5513
Ph: (727) 823-2188 | Charles Moore Boothby, DO
3890 Tampa Rd, Suite 201,
Palm Harbor, FL 34684-3676
Ph: (727) 781-3111 |
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