Individual provider Active NPI

Rocio Puentes, M.D.

  • Psychiatry Physician
  • Tampa, FL
National Provider Identifier
1477997138
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME131274 Issued in FL
Practice address
5707 N 22ND St
Tampa, FL 33610-4350
Phone
(813) 272-2244
Fax
(813) 272-3766
NPI assigned
Apr 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X IP1434 KY
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X ME131274 FL Primary

Addresses

Primary practice location

5707 N 22ND St
Tampa, FL 33610-4350

Mailing address

5707 N. 22ND Street
Tampa, FL 33610

Other practice location 1

800 Rose St
Lexington, KY 40536-0001
Phone (859) 323-5871

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170825001106 FL Practitioner - Psychiatry 0143501171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ibis Healthcare IncGroup PAC ID 2769469204, 24 clinicians

Practice addresses (Care Compare)

5707 - N 22ND St
Tampa, FL 33610-4350
Phone (813) 239-8069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME131274FLMDPsychiatry Physician
IP1434KYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ibis Healthcare Inc CurrentSince Jul 17, 2017 Accepting new patients
Ibis Healthcare Inc CurrentSince Jul 17, 2017 Accepting new patients

Locations

5707 N 22nd St
Tampa, FL 33610
Phone (813) 272-2244

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1477997138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 N. 22ND STREET",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 N 22ND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336104350",
            "telephone_number": "813-272-2244",
            "fax_number": "813-272-3766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Rose St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-323-5871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUENTES",
        "first_name": "ROCIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "IP1434",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME131274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.