Individual provider Active NPI

Ion Botnaru, M.D.

  • Cardiovascular Disease Physician
  • Palm Harbor, FL
National Provider Identifier
1174796080
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME146402 Issued in FL
Practice address
4705 Alt 19 Ste B
Palm Harbor, FL 34683-1424
Phone
(727) 787-4875
Fax
(727) 786-9623
NPI assigned
Apr 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60633873 WA
Cardiovascular Disease Physician 207RC0000X MD60633873 WA
Interventional Cardiology Physician 207RI0011X MD60633873 WA
Interventional Cardiology Physician 207RI0011X ME146402 FL
Nuclear Cardiology Physician 207UN0901X ME146402 FL
Cardiovascular Disease Physician 207RC0000X ME146402 FL Primary

Addresses

Primary practice location

4705 Alt 19 Ste B
Palm Harbor, FL 34683-1424

Mailing address

4705 Alt 19 Ste B
Palm Harbor, FL 34683-1424
Phone (727) 787-4875

Other practice location 1

406 Black Hills Ln SW
Olympia, WA 98502-8143
Phone (360) 754-1737

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
I20210108001083 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 0446326961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

4705 Alt
19 Suite B
Palm Harbor, FL 34683-1424
Phone (727) 935-6477

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting16
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME146402FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc Internal Medicine CurrentSince Feb 15, 2021 Accepting new patients
Quincy Physician Corporation Internal Medicine Past Accepting new patients

Locations

4705 Alt 19
Ste B
Palm Harbor, FL 34683
Phone (727) 787-4875

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

4111 Little Rd
Trinity, FL 34655
Phone (727) 938-1908

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: ibotnaru73871@adventhealth.direct-ci.com

Organizations & group practices 2

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

Hospital & facility affiliations 3

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": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1174796080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 ALT 19 STE B",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831424",
            "telephone_number": "727-787-4875",
            "fax_number": "727-786-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 ALT 19 STE B",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831424",
            "telephone_number": "727-787-4875",
            "fax_number": "727-786-9623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 Black Hills Ln SW",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985028143",
            "country_code": "US",
            "telephone_number": "360-754-1737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTNARU",
        "first_name": "ION",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-11",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60633873",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD60633873",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WA",
            "license": "MD60633873",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME146402",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "FL",
            "license": "ME146402",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME146402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.