Charles R Hollen, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME354369 Issued in FL

Practice address

3333 Cattlemen Rd Ste 208
Sarasota, FL 34232-6058

Phone

(941) 379-5121

Fax

(941) 379-4239

NPI assigned

Feb 14, 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

Electronic endpoints 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

Internal Medicine

Education

Medical College of Ohio, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Intercoastal Medical Group IncGroup PAC ID 6305730912, 176 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Creekside Health and Rehabilitation Center Nursing home, Sarasota, FL, CCN 105454

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.hollen@img.directbygreenway.com

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.

• Intercoastal Medical Group Inc

  • Family Medicine Physician
  • Sarasota, FL
  • NPI 1578537767

  Internal Medicine

  Medicare reassignment Care Compare group NPD

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

• Creekside Rehab Opco, LLC

  dba Creekside Health and Rehabilitation Center

  • Skilled Nursing Facility
  • Sarasota, FL
  • NPI 1952016214

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1447224845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 CATTLEMEN RD STE 208",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326058",
            "telephone_number": "941-379-5121",
            "fax_number": "941-379-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 CATTLEMEN RD STE 208",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326058",
            "telephone_number": "941-379-5121",
            "fax_number": "941-379-4239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEN",
        "first_name": "CHARLES",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME354369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crpcpdsm@img.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3333 Cattlemen Rd",
            "address_2": "Suite 208",
            "city": "Sarasota",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342326056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Holiday CVS LLC (CVS Pharmacy #17127)
• Holiday CVS, L.L.C. (CVS Pharmacy # 11382)
• Holistic Healing Acupunture, LLC (Holistic Healing Acupunture)
• Reuben W Holland, MD
• Tracey Holland, M.S.
• Jordana Werner Hollen, M.D.
• Tyler Rowland Hollen, M.D.
• Holli L Bodner Psy D P a
• Cheryl Ross Hollifield, CNM
• Kathryn Taylor Hollingsworth, ARNP

• Internal Medicine Physician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.
• 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.