Individual provider Active NPI

Diana Maria Ronderos Botero, MD

  • Pulmonary Disease Physician
  • Vero Beach, FL
National Provider Identifier
1568966562
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
161567 Issued in FL
Practice address
3450 11TH CT Ste 306
Vero Beach, FL 32960-5012
Phone
(772) 794-5800
NPI assigned
Mar 23, 2018
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 161567 FL Primary

Addresses

Primary practice location

3450 11TH CT Ste 306
Vero Beach, FL 32960-5012

Mailing address

5700 Bent Pine SQ
Vero Beach, FL 32967-7526
Phone (201) 657-2731

Other names 1

  • Mrs. Diana Maria Ronderos Botero Other name

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
I20230628004422 FL Practitioner - Pulmonary Disease 1658730395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Indian River Health Services IncGroup PAC ID 9234130329, 335 clinicians

Practice addresses (Care Compare)

3450 11TH CT
Vero Beach, FL 32960-5012
Phone (772) 794-5800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
161567FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Health Services Inc CurrentSince Jul 24, 2023 Accepting new patients
Indian River Health Services Inc CurrentSince Jul 24, 2023 Accepting new patients
Indian River Health Services Inc Past Accepting new patients

Locations

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

3450 11th Ct
Ste 306
Vero Beach, FL 32960
Phone (772) 567-6140

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1568966562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 BENT PINE SQ",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329677526",
            "telephone_number": "201-657-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 11TH CT STE 306",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605012",
            "telephone_number": "772-794-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONDEROS BOTERO",
        "first_name": "DIANA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "161567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "RONDEROS BOTERO",
            "middle_name": "MARIA",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.