Individual provider Active NPI

Ausberto Bienvenido Hidalgo

  • General Practice Physician
  • Pembroke Pines, FL
National Provider Identifier
1144385592
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME0053208 Issued in FL
Practice address
302 NW 179TH Avenue
Suite 103
Pembroke Pines, FL 33029-2810
Phone
(954) 442-8380
Fax
(954) 442-8661
NPI assigned
Dec 26, 2006
Last updated
Jan 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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 ME0053208 FL Primary

Addresses

Primary practice location

302 NW 179TH Avenue
Suite 103
Pembroke Pines, FL 33029-2810

Mailing address

302 NW 179TH Avenue
Suite 103
Pembroke Pines, FL 33029-2810
Phone (954) 442-8380

Other identifiers 1

IdentifierTypeStateIssuer
049046600MedicaidFL

Other names 1

  • Ausberto B Hidalgo Professional name

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
I20080922000355 FL Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 5597651760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

302 NW 179TH Ave
Suite 103
Pembroke Pines, FL 33029-2904
Phone (954) 442-8380

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0053208FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Urgent Care Centers, LLC CurrentSince Dec 10, 2016 Accepting new patients
South Florida Urgent Care Centers, LLC Past Accepting new patients
South Florida Urgent Care Centers, LLC Past Accepting new patients
South Florida Urgent Care Centers, LLC Past Accepting new patients
South Florida Urgent Care Centers, LLC Past Accepting new patients
South Florida Urgent Care Centers, LLC Past Accepting new patients

Locations

302 NW 179th Ave
Ste 103
Pembroke Pines, FL 33029
Phone (954) 442-8380

Organizations & group practices 7

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1144385592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 NW 179TH AVENUE",
            "address_2": "SUITE 103",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292810",
            "telephone_number": "954-442-8380",
            "fax_number": "954-442-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 NW 179TH AVENUE",
            "address_2": "SUITE 103",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292810",
            "telephone_number": "954-442-8380",
            "fax_number": "954-442-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIDALGO",
        "first_name": "AUSBERTO",
        "middle_name": "BIENVENIDO",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME0053208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049046600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUSBERTO",
            "last_name": "HIDALGO",
            "middle_name": "B",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.