Active NPI
Rene Mario Loyola, M.D.
- Internal Medicine Physician
- Port St Lucie, FL
National Provider Identifier
1528066941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME0033328
- Practice address
- 1400 SE Goldtree Dr
Suite 102-104
Port St Lucie, FL 34952-7582 - Phone
- (772) 335-8446
- Fax
- (772) 335-8499
- NPI assigned
- Jul 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME0033328 | FL | Primary |
Addresses
Primary practice location
1400 SE Goldtree Dr
Suite 102-104
Port St Lucie, FL 34952-7582
Mailing address
1400 SE Goldtree Dr
Suite 102-104
Port St Lucie, FL 34952-7582
Phone (772) 335-8446
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 068483000 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Undersea and Hyperbaric Medicine
- Education
- Other, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2000 Health Park Dr
Brentwood, TN 37027-4692
Hospital & facility affiliations
- St Lucie Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 23 |
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0033328 | FL | MD | Internal Medicine Physician |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Port St Lucie, FL
- NPI 1538115696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615334400000",
"number": "1528066941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 SE GOLDTREE DR",
"address_2": "SUITE 102-104",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349527582",
"telephone_number": "772-335-8446",
"fax_number": "772-335-8499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 SE GOLDTREE DR",
"address_2": "SUITE 102-104",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349527582",
"telephone_number": "772-335-8446",
"fax_number": "772-335-8499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOYOLA",
"first_name": "RENE",
"middle_name": "MARIO",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-09",
"last_updated": "2021-03-10",
"certification_date": "2021-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME0033328",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "068483000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.