Lina Marcela Rengifo Bedoya, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME158910 Issued in FL

Practice address

712 39TH St W
Bradenton, FL 34205-2454

Phone

(941) 748-4602

Fax

(941) 567-3361

NPI assigned

Jul 10, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lina.rengifo.bedoya.1@11352.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.

• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  Medicare reassignment NPD
• MCR Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• MCR Health, Inc.

  • Family Medicine Physician
  • Bradenton, FL
  • NPI 1730115882
  NPD (past)
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Palmetto, FL
  • NPI 1841236247

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1386296366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIVERFRONT BLVD STE 710",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058812",
            "telephone_number": "941-776-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 39TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342052454",
            "telephone_number": "941-748-4602",
            "fax_number": "941-567-3361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271570001",
            "country_code": "US",
            "telephone_number": "336-716-6410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENGIFO BEDOYA",
        "first_name": "LINA",
        "middle_name": "MARCELA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME158910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stelios Rekkas, MD
• Reliable Medical Supply LLC
• Renaissance Healthcare
• Jean-Joseph Ganeau Rendel Jr., DNP, FNP-BC,PMHNP-BC
• Vanessa Leigh Rene, RPHT, CPHT
• Rodolfo E Reni, M.D.
• Noelle Rennie
• Kay Helen Renshaw, RD, LD/N
• Yaqueline Renteria
• Lisa M Reo, LCPC, PMH

• Pediatrics Physician in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.