Individual provider Active NPI

Ricardo Jesus Barranon, MD

  • Family Medicine Physician
  • Lake Wales, FL
National Provider Identifier
1073189148
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME167840 Issued in FL
Practice address
1255 State Road 60 E Ste 500
Lake Wales, FL 33853-4302
Phone
(863) 676-8237
Fax
(863) 676-8207
NPI assigned
May 31, 2021
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME167840 FL Primary

Addresses

Primary practice location

1255 State Road 60 E Ste 500
Lake Wales, FL 33853-4302

Mailing address

1255 State Road 60 E Ste 500
Lake Wales, FL 33853-4302
Phone (863) 676-8237

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
I20241024000088 FL Practitioner - Family Practice 0648703074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

1255 State Rd 60
Suite 400
Lake Wales, FL 33853-4310
Phone (863) 676-8237

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME167840FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Primary Care Network Inc Family Medicine CurrentSince Nov 4, 2024 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

1255 State Road 60 E
Ste 400
Lake Wales, FL 33853
Phone (863) 676-2272

1255 State Road 60 E
Ste 500
Lake Wales, FL 33853
Phone (844) 634-3627

Interoperability endpoints

  • Direct secure messaging: rbarranon3788329@adventhealth.direct-ci.com
  • Direct secure messaging: ricado.barranon@direct.mybaycare.org

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1622419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1073189148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 STATE ROAD 60 E STE 500",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534302",
            "telephone_number": "863-676-8237",
            "fax_number": "863-676-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 STATE ROAD 60 E STE 500",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534302",
            "telephone_number": "863-676-8237",
            "fax_number": "863-676-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRANON",
        "first_name": "RICARDO",
        "middle_name": "JESUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-31",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME167840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

Verify at the official NPI Registry.