Individual provider Active NPI

Mario R Palomino, MD

  • General Practice Physician
  • Hialeah, FL
National Provider Identifier
1043229164
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME87046 Issued in FL
Practice address
3805 W 20TH Ave
Suite 105
Hialeah, FL 33012-4532
Phone
(305) 557-2277
Fax
(305) 557-2278
NPI assigned
Aug 7, 2006
Last updated
Jan 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME87046 FL Primary

Addresses

Primary practice location

3805 W 20TH Ave
Suite 105
Hialeah, FL 33012-4532

Mailing address

6100 Blue Lagoon Dr Ste 365
Miami, FL 33126-7010
Phone (786) 322-7333

Other identifiers 1

IdentifierTypeStateIssuer
263813401MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mario.palomino@cmg.eclinicaldirectplus.com Other

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040223000964 FL Practitioner - General Practice 6709772221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Medical Group of Hialeah, LLCGroup PAC ID 3971740705, 3 clinicians

Practice addresses (Care Compare)

3805 W 20TH Ave
Suite 105
Hialeah, FL 33012-4532
Phone (305) 557-2277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Access Medical Group of Westchester, LLC. General Practice CurrentSince Jul 23, 2013 Accepting new patients
Access Medical Group of Hialeah, LLC. General Practice CurrentSince Mar 19, 2015 Accepting new patients
Access Medical Group of Miami, LLC. General Practice CurrentSince Feb 1, 2014 Accepting new patients
American Technical Academy Group Corp Past Accepting new patients
Doctor's Medical Center, LLC PastSince Mar 22, 2020 Accepting new patients
Continental Rehab Center, Inc Past Accepting new patients
Ideal Medical Center of Miami PastSince Feb 1, 2014 Accepting new patients
Comprehensive Community Guidance Center Inc Past Accepting new patients
Anesthesia Consultants of South Florida Inc Past Accepting new patients

Locations

3805 W 20th Ave
Ste 105
Hialeah, FL 33012
Phone (305) 557-2277

1490 NW 27th Ave
Ste 130
Miami, FL 33125
Phone (305) 635-7710

1621 SW 107th Ave
Miami, FL 33165
Phone (786) 422-6525

6100 Blue Lagoon Dr
Ste 365
Miami, FL 33126
Phone (786) 322-7333

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IAFJBD

Organizations & group practices 9

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1043229164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 BLUE LAGOON DR STE 365",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331267010",
            "telephone_number": "786-322-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 W 20TH AVE",
            "address_2": "SUITE 105",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124532",
            "telephone_number": "305-557-2277",
            "fax_number": "305-557-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOMINO",
        "first_name": "MARIO",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME87046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263813401",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mario.palomino@cmg.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "health information has changed",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "3805 W 20th Ave",
            "address_2": "Suite 105",
            "city": "Hialeah",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330124532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.