Jose A Bocanegra Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35082489 Issued in OH

Practice address

10139 Royalton Rd Ste H
North Royalton, OH 44133-4473

Phone

(440) 816-2878

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH, TX2 enrollments

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 2

Specialty

Family Practice

Education

Ohio State University College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Glen Rose Healthcare, IncGroup PAC ID 6709986656, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Granbury, TX, CCN 679021
• Glen Rose Medical Center Hospital, Glen Rose, TX, CCN 450451
• Southwest General Health Center Hospital, Middleburg Heights, OH, CCN 360155

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1948/brand/1/csg/1/fhir/r4
• Direct secure messaging: jose.bocanegra.1@1948.direct.athenahealth.com

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.

• Glen Rose Healthcare, Inc

  • Family Medicine Physician
  • Glen Rose, TX
  • NPI 1568509586
  Medicare reassignment Care Compare group NPD
• Southwest General Medical Group Inc

  • Internal Medicine Physician
  • Cleveland, OH
  • NPI 1134239676

  Family Medicine

  Medicare reassignment NPD
• Southwest General Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Middleburg HTS, OH
  • NPI 1588393979
  NPD
• Clinic Regional Physicians LLC

  • Internal Medicine Physician
  • Beachwood, OH
  • NPI 1043470453

  Family Medicine

  NPD (past)
• Meridia Medical Group, LLC

  • Specialist
  • Warrensville Heights, OH
  • NPI 1316992944
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southwest General Health Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1154353993
  Care Compare affiliation
• Eh of Fort Worth, LP

  • Home Health Agency
  • Granbury, TX
  • NPI 1730331414
  Care Compare affiliation
• Somervell County Hospital District

  • Rural Acute Care Hospital
  • Glen Rose, TX
  • NPI 1700826575
  Care Compare affiliation

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1316033475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638269",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452638269",
            "telephone_number": "440-816-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10139 ROYALTON RD STE H",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441334473",
            "telephone_number": "440-816-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCANEGRA",
        "first_name": "JOSE",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35082489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVDER ID#",
            "identifier": "0007456582",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2479442",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "1003087",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "000000350199",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbocanegra@direct.swgeneral.com",
            "affiliation": "Y",
            "affiliationName": "Southwest General Medical Group Inc",
            "address_1": "10139 Royalton Rd Ste H",
            "city": "North Royalton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441334473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Behavioral Health Consulting Group, Inc.
• Rebecca Constance Bellflower, PHARM.D.
• Raymond M Bilecky, PT
• Rachel E Birch, PT, DPT
• Blue Dart LLC
• Abbey Elaine Bonasso
• William Dibello Bonus, COTA/L
• Daniel I Borison, M.D
• Angela Borisov, APRN, FNP-C
• Andrew Bradley

• Family Medicine Physician in North Royalton, OH
• Providers in North Royalton, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.