Individual provider Active NPI

Alvaro Ramon Bada, MD

  • Surgery Physician
  • Port Charlotte, FL
National Provider Identifier
1023074911
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME39970 Issued in FL
Practice address
18308 Murdock Circle
#101
Port Charlotte, FL 33948
Phone
(941) 255-0069
Fax
(941) 255-0072
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME39970 FL Primary

Addresses

Primary practice location

18308 Murdock Circle
#101
Port Charlotte, FL 33948

Mailing address

18308 Murdock Circle
#101
Port Charlotte, FL 33948
Phone (941) 255-0069

Other identifiers 1

IdentifierTypeStateIssuer
043820100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME39970FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Domingo E Galliano Jr PA Surgery PastSince Oct 1, 1999 Accepting new patients
Advanced Wound Systems LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17708/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1023074911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18308 MURDOCK CIRCLE",
            "address_2": "#101",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33948",
            "telephone_number": "941-255-0069",
            "fax_number": "941-255-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18308 MURDOCK CIRCLE",
            "address_2": "#101",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33948",
            "telephone_number": "941-255-0069",
            "fax_number": "941-255-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADA",
        "first_name": "ALVARO",
        "middle_name": "RAMON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME39970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043820100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.