Jorge Juan Bacallao, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME 92076 Issued in FL

Practice address

5858 SW 68TH St
South Miami, FL 33143-3693

Phone

(305) 661-8588

Fax

(305) 661-4906

NPI assigned

Jul 31, 2006

Last updated

Feb 15, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Ophthalmology

Education

Other, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Selem Center, LLCGroup PAC ID 7113119306, 4 clinicians

Kendall Eye Institute IncGroup PAC ID 2769562560, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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

State licenses

Practice roles

Locations

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.

• Kendall Eye Institute Inc

  • Specialist
  • Miami, FL
  • NPI 1639367261
  Medicare reassignment Care Compare group NPD
• A James Segal MD PA Medeyeassociates

  • Ophthalmology Physician
  • South Miami, FL
  • NPI 1710907522
  Medicare reassignment
• Selem Center, LLC

  • Ophthalmology Physician
  • Coral Gables, FL
  • NPI 1336450006
  Care Compare group
• Aran Eye Associates PA

  • Specialist
  • Coral Gables, FL
  • NPI 1295832582
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518652800000",
    "number": "1275549511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5858 SW 68TH ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331433693",
            "telephone_number": "305-661-8588",
            "fax_number": "305-661-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5858 SW 68TH ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331433693",
            "telephone_number": "305-661-8588",
            "fax_number": "305-661-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACALLAO",
        "first_name": "JORGE",
        "middle_name": "JUAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2018-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME 92076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268789500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Irene Ayala
• Anum Ayaz, MD
• Roxana Maday Ayllon
• Sumamol Ayyappan, AGACNP-BC
• Stephanie Victoria Azan, M.S. CF-SLP
• Allison Badia Gonzalez, LMT
• Esra Baglar
• Bagnell Chiropractic Center
• Payal Bai
• Nazish Bais, MD

• Ophthalmology Physician in South Miami, FL
• Providers in South Miami, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.