Richard M Bardales, M.D.
Individual provider Active NPI Cardiovascular Disease Physician · Lancaster, OH
NPI 1619978889 · NPPES record last updated Nov 17, 2011
Key facts
- NPI
- 1619978889
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 35074693 (OH)
- Practice address
- 618 Pleasantville Rd
Ste 101
Lancaster, OH 43130-3312 - Phone
- (740) 653-7511
- Fax
- (740) 653-7512
- NPI assigned
- Aug 10, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050603000458 | OH | Practitioner - Cardiovascular Disease (Cardiology) | 3678516374 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35074693 | OH | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiovascular Specialists, LLC | Cardiovascular Disease | Current |
Accepting new patients |
| Cardiovascular Specialists, LLC | Cardiovascular Disease | Current | Accepting new patients |
| Cardiovascular Specialists, LLC | Cardiovascular Disease | Current |
Accepting new patients |
| Capitol City Cardiology, Inc. | Cardiovascular Disease | Past | Accepting new patients |
Locations
618 Pleasantville Rd
Ste 102
Lancaster, OH 43130
Phone (740) 475-0502
618 Pleasantville Rd
Ste 101
Lancaster, OH 43130
Phone (740) 475-0501
601 State Route 664 N
Logan, OH 43138
Phone (740) 380-8000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 35074693 | OH | Yes |
Addresses
Primary practice location
618 Pleasantville Rd
Ste 101
Lancaster, OH 43130-3312
Mailing address
618 Pleasantville Rd
Suite 101
Lancaster, OH 43130-3312
Phone (740) 653-7511
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2087898 | Medicaid | OH |
Other providers in Lancaster, OH
- Scott R Baker
- Matthew Balasco
- Sharon Bankes
- Mary Beth Barbush-Kirila
- Delores Ellen Bardales
- Terry Douglas Barkley
- Stephen Barnett
- Kelli Barnhart
- Suzanne M Barnhart
- Bethanny Joy Barno
All providers in Lancaster, OH · Cardiovascular Disease Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.