Individual provider Active NPI

Hugo F Ventura Tavares, MD

  • Internal Medicine Physician
  • Brandon, FL
National Provider Identifier
1629034483
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ACN415 Issued in FL
Practice address
1111 Oakfield Dr Ste 114
Brandon, FL 33511-4948
Phone
(813) 324-9899
Fax
(813) 502-6111
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22351 WV
Internal Medicine Physician 207R00000X 4301086975 MI
Internal Medicine Physician 207R00000X 9351 PR
Internal Medicine Physician 207R00000X ACN415 FL Primary

Addresses

Primary practice location

1111 Oakfield Dr Ste 114
Brandon, FL 33511-4948

Mailing address

1111 Oakfield Dr Ste 114
Brandon, FL 33511-4948
Phone (787) 485-2914

Other names 1

  • Hugo F Ventura Tavares Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130506000451 VI Practitioner - Internal Medicine 7416058037 Practice locations: Christiansted, VI
I20160421000944 FL Practitioner - Internal Medicine 7416058037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1387 Oakfield Dr
Brandon, FL 33511-4862
Phone (813) 334-9899

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9351PRMDSocial Worker
ACN415FLMDInternal Medicine Physician
22351WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Place for Your Health, LLC Internal Medicine CurrentSince Aug 16, 2016 Accepting new patients
Kristi L Conway DPM PA PastSince Nov 15, 2015 Accepting new patients
Wetzel County Hospital Association Past Accepting new patients

Locations

411 Lithia Pinecrest Rd
Brandon, FL 33511
Phone (813) 334-9899

1111 Oakfield Dr
Ste 114
Brandon, FL 33511
Phone (813) 385-8721

1387 Oakfield Dr
Brandon, FL 33511
Phone (813) 334-9899

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 and National Provider Directory roles.

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1629034483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 OAKFIELD DR STE 114",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114948",
            "telephone_number": "787-485-2914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 OAKFIELD DR STE 114",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114948",
            "telephone_number": "813-324-9899",
            "fax_number": "813-502-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTURA TAVARES",
        "first_name": "HUGO",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "22351",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301086975",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "9351",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ACN415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HUGO",
            "last_name": "VENTURA TAVARES",
            "middle_name": "F",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.