Ricardo Jesus Barranon, MD
Individual provider Active NPI Family Medicine Physician · Lake Wales, FL
NPI 1073189148 · NPPES record last updated Sep 27, 2024
Key facts
- NPI
- 1073189148
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- ME167840 (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
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 5
Medicare Care Compare profile
- 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 Inc
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
- Adventhealth Home Health
- Adventhealth Lake Wales
- Adventhealth Heart of Florida
- Adventhealth Orlando
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241024000088 | FL | Practitioner - Family Practice | 0648703074 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME167840 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventhealth Primary Care Network Inc | Family Medicine | Current |
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
- rbarranon3788329@adventhealth.direct-ci.com
- ricado.barranon@direct.mybaycare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME167840 | FL | Yes |
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
Other providers in Lake Wales, FL
- Jean Fritzner Balan
- Bangash Dentistry PLLC
- Maryam Bangash
- Santelia Barnes
- Heather Watson Barranco
- William Barringer
- Barringer,Nelson & Holmes PA
- Vickie Barron
- Getzline Basse
- Jennifer Bayron
All providers in Lake Wales, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.