NPIMap

Individual provider Active NPI

Nicolas Gabriel Bezares Oliveras, MD

  • Internal Medicine Physician
  • Lake Mary, FL
National Provider Identifier
1659950152
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME165207 Issued in FL
Practice address
525 Technology Park Ste 109
Lake Mary, FL 32746-7107
Phone
(407) 647-2346
NPI assigned
Apr 3, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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 ME165207 FL Primary

Addresses

Primary practice location

525 Technology Park Ste 109
Lake Mary, FL 32746-7107

Mailing address

11375 Cortez Blvd
Brooksville, FL 34613-5409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241028000824 FL Practitioner - Internal Medicine 8123551363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Care Specialists LLCGroup PAC ID 0345493623, 101 clinicians

Practice addresses (Care Compare)

600 E Dixie Ave
Leesburg, FL 34748-5925
Phone (407) 647-2346

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME165207FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Care Specialists LLC CurrentSince Aug 23, 2024 Accepting new patients

Locations

502 W Highland Blvd
Inverness, FL 34452
Phone (352) 344-6481

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

600 E Dixie Ave
Leesburg, FL 34748
Phone (352) 323-5090

Interoperability endpoints

  • Direct secure messaging: nicolas.bezaresoliveras@hca4.eclinicaldirectplus.com
  • Direct secure messaging: nbezaresoliveras712471@direct.shands.ufl.edu

Organizations & group practices 1

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 12

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": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1659950152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11375 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 TECHNOLOGY PARK STE 109",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467107",
            "telephone_number": "407-647-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZARES OLIVERAS",
        "first_name": "NICOLAS",
        "middle_name": "GABRIEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-03",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME165207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.