Nicholas G. Bagnoli DO PA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

NICHOLAS G. BAGNOLI DO PA

Practice address

1220 Sligh Blvd
Orlando, FL 32806-1108

Phone

(407) 210-4251

Fax

(407) 648-0968

NPI assigned

Feb 4, 2010

Last updated

Mar 25, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

NICHOLAS G, BAGNOLI DO PAAs reported in NPPES

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

Authorized official

Name

Dr. Nicholas G Bagnoli, MDNPI 1598719411

Title

Owner

Phone

(407) 210-4251

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Part of

Nicholas G Bagnoli DO PA

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas G. Bagnoli, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Orlando, FL
  • NPI 1598719411
  Medicare reassignment NPD Authorized official
• Jerry Ragnauth, ARNP

  • Nurse Practitioner
  • Ocoee, FL
  • NPI 1154300895
  NPD (past)
• Robert D. Dieter, PA-C

  • Medical Physician Assistant
  • Spokane, WA
  • NPI 1194845586
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269475200000",
    "number": "1730411430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3869 WINDERLAKES DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328352625",
            "telephone_number": "407-210-4251",
            "fax_number": "407-648-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 SLIGH BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061108",
            "telephone_number": "407-210-4251",
            "fax_number": "407-648-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS G. BAGNOLI DO PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NICHOLAS G, BAGNOLI DO PA",
        "enumeration_date": "2010-02-04",
        "last_updated": "2010-03-25",
        "status": "A",
        "authorized_official_last_name": "BAGNOLI",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-210-4251",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252446500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allen Ni
• Lucille Arlene Nibbs-James, M.S.
• Kiefanie Nibbs, LMHC
• Bobby Nibhanupudy, MD
• Nich'K Beauty RX
• Nicholas Le OD LLC
• Brooke Ashlyn Nicholas, DNP
• Irene Nicholas
• Natacha M Nicholas
• Nichelle Maria Nicholas

• Physical Medicine & Rehabilitation Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.