Individual provider Active NPI

Alejandro Andion Bacallao

  • Family Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1043078165
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11031765 Issued in FL
Practice address
5867 Nottingham Rd
West Palm Beach, FL 33415-6363
Phone
(561) 215-6068
NPI assigned
Mar 12, 2024
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11031765 FL Primary

Addresses

Primary practice location

5867 Nottingham Rd
West Palm Beach, FL 33415-6363

Mailing address

5867 Nottingham Rd
West Palm Beach, FL 33415-6363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240711002369 FL Practitioner - Nurse Practitioner 3072058239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Castillo Andtorres MD PAGroup PAC ID 0446477285, 7 clinicians

Practice addresses (Care Compare)

2328 S Congress Ave
Suite 1E
Palm Springs, FL 33406-7671
Phone (561) 324-7224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11031765FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Castillo & Torres MD PA CurrentSince Jun 2, 2024 Accepting new patients

Locations

2328 S Congress Ave
Ste 1E
West Palm Beach, FL 33406
Phone (561) 324-7224

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73339

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1043078165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5867 NOTTINGHAM RD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334156363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5867 NOTTINGHAM RD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334156363",
            "telephone_number": "561-215-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDION BACALLAO",
        "first_name": "ALEJANDRO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11031765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.