Individual provider Active NPI

Rene Mario Loyola, M.D.

  • Internal Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1528066941
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0033328 Issued in FL
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

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
068483000MedicaidFL

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
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Undersea and Hyperbaric MedicineAlso: Internal 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 Hospital, Port Saint Lucie, FL, CCN 100260

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue23
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0033328FLMDInternal 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.

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

Verify at the official NPI Registry.