Ivan Dario Escobar Roldan

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME155308 Issued in FL

Practice address

5325 26TH St W
Bradenton, FL 34207-3012

Phone

(941) 752-7173

Fax

(941) 567-6277

NPI assigned

Jul 27, 2018

Last updated

Jul 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Specialty

Psychiatry

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MCR Health IncGroup PAC ID 7214847995, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ivan.escobar.roldan.1@11352.direct.athenahealth.com

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.

• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  Medicare reassignment Care Compare group NPD
• MCR Health, Inc.

  dba Riverside Medical Center

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1770060204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIVERFRONT BLVD STE 710",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058812",
            "telephone_number": "941-776-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 26TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342073012",
            "telephone_number": "941-752-7173",
            "fax_number": "941-567-6277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Erwin Rd",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277054699",
            "country_code": "US",
            "telephone_number": "919-684-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESCOBAR ROLDAN",
        "first_name": "IVAN",
        "middle_name": "DARIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-27",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "237864",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME155308",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "237864",
            "primary": false
        },
        {
            "code": "246YC3302X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Health Information, Coding Specialist, Physician Office Based",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Erickson, APRN
• Bengt Ericsson, B.C.-H.I.S.
• Tara Eriksen, OTR
• Erin C Morales LLC
• Ervin E. Bernotus MD, P.a.
• Francisco Higinio Esparza, MD
• Alfonso Luis Espinel, M.D,
• Jorge E Espino, CRNA
• Francisco J Espinoza Sr., DDS PA
• Nadia Esquijarosa

• Psychiatry Physician in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.