Leonel P Welch Basulto, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

201859686 Issued in FL

Practice address

3269 Highway 90
Bonifay, FL 32425-6001

Phone

(850) 547-9991

Fax

(850) 547-9992

NPI assigned

Jul 7, 2006

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 2

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

Family Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Doctors Memorial Hospital Hospital, Bonifay, FL, CCN 101307
• Northwest Florida Community Hospital Hospital, Chipley, FL, CCN 101308
• Flowers Hospital Hospital, Dothan, AL, CCN 010055

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lwelch@direct.cghospital.org

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jimmy Rafael Carrillo, PA-C

  • Medical Physician Assistant
  • Bonifay, FL
  • NPI 1285910778
  Medicare reassignment

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.

• Holmes County Hospital Corp

  • Critical Access Hospital
  • Bonifay, FL
  • NPI 1366431702
  Medicare reassignment NPD
• Campbellton-Graceville Hospital

  • Critical Access Hospital
  • Graceville, FL
  • NPI 1205886280
  NPD
• Holmes County Hospital Corp

  • Rural Health Clinic/Center
  • Bonifay, FL
  • NPI 1952917015
  NPD
• The Pathology Group of Northwest Florida PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
  • NPI 1114153269
  NPD
• Vivid Pathology PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
  • NPI 1760738611
  NPD
• Mason Carnley FNP-C, LLC

  • Family Nurse Practitioner
  • Panama City, FL
  • NPI 1184512212
  NPD (past)
• Samuel E Ward MD PL

  • Family Medicine Physician
  • Vernon, FL
  • NPI 1255319695
  NPD (past)

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

• Holmes County Hospital Corp

  • Critical Access Hospital
  • Bonifay, FL
  • NPI 1366431702
  Care Compare affiliation
• Northwest Florida Healthcare, Inc

  • Critical Access Hospital
  • Chipley, FL
  • NPI 1336163708
  Care Compare affiliation
• Triad of Alabama LLC

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1801830500
  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1316970262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 HIGHWAY 90 EAST",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324256001",
            "telephone_number": "850-547-9991",
            "fax_number": "850-547-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 HIGHWAY 90",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324256001",
            "telephone_number": "850-547-9991",
            "fax_number": "850-547-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH BASULTO",
        "first_name": "LEONEL",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "201859686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266925100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "201859686",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer C Torbett
• Tri-County Community Council, Inc.
• US Recovery Centers, LLC
• Symmone Ward
• Madison Webster
• Angele Wesley
• Tekisha White
• Shelby Johnson Whitehead, APRN
• Casey Gainey Whitman, LMHC
• William R Cook Padgett Drugs

• Family Medicine Physician in Bonifay, FL
• Providers in Bonifay, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.