Agustin Caballero- Perez, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ACN958 Issued in FL

Practice address

Da19 Calle 167
Jardines of Country Club
Carolina, PR 00983-2158

Phone

(787) 607-5848

NPI assigned

Jul 1, 2009

Last updated

Oct 11, 2017By 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 2

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

General Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medical Home Alliance, LLCGroup PAC ID 6406096536, 60 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Medical Home Alliance LLC

  • Internal Medicine Physician
  • Davenport, FL
  • NPI 1740527811

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Medical Home Alliance, LLC

  dba IMA Medical Group St. Cloud

  • Internal Medicine Physician
  • Saint Cloud, FL
  • NPI 1790458396
  NPD
• Medical Home Alliance LLC

  dba IMA Winter Haven Dispensary

  • Non-Pharmacy Dispensing Site
  • Winter Haven, FL
  • NPI 1033648233
  NPD (past)

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1275761975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 WESTWOOD BLVD",
            "address_2": "STE 475",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328216027",
            "telephone_number": "407-845-0330",
            "fax_number": "888-972-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DA19 CALLE 167",
            "address_2": "JARDINES OF COUNTRY CLUB",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009832158",
            "telephone_number": "787-607-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABALLERO- PEREZ",
        "first_name": "AGUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17642",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUERTO RICO PHYSCIAN",
            "identifier": "17642",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zayelit Mairim Budet
• Kevin A Buenahora Medina, MD
• Felix R. Bultron
• Javier Ricardo Burgos, M.D.
• Maria Socorro Burgos
• Luis E Caballero
• Carmen S Caban Espinosa, M.D.
• Ana Caban, PHARMACIST
• Hector Manuel Caban, MD
• Maria G Cabassa, PH

• General Practice Physician in Carolina, PR
• Providers in Carolina, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; 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.