Carlos Alberto Botero, M.D.

Key facts

NPI

1902880933

Entity type

Individual (NPI type 1)

Primary specialty

Interventional Pain Medicine Physician 208VP0014X

License

ME72561 (FL)

Practice address

541 S Florida Ave
Lakeland, FL 33801-5228

Phone

(863) 682-7246

Fax

(863) 682-5566

NPI assigned

Dec 2, 2005

Sex

Male

Sole proprietor

Yes

Organizations & group practices 4

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.

• Lockwood & Steely, MD'S, PA Pain Medicine (Anesthesiology) Physician · Plant City, FL · NPI 1972697266
  Medicare reassignment Care Compare group NPD FL
• Pain Medicine Inc Pain Medicine Physician · Lakeland, FL · NPI 1376706283
  Medicare reassignment Care Compare group NPD ANESTHESIOLOGY · FL
• Lakeland FL Endoscopy ASC LLC Ambulatory Surgical Clinic/Center · Lakeland, FL · NPI 1649244567
  Medicare reassignment NPD FL
• Polk County Anesthesia Anesthesiology Physician · Bartow, FL · NPI 1558394940
  NPD (past) ANESTHESIOLOGY

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Florida Baptist Hospital Inc General Acute Care Hospital · Plant City, FL · NPI 1548205883
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Anesthesiology
Also: Pain Management

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lockwood and Steely, MD'S, PA (19 clinicians)
Pain Medicine Inc (4 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Florida Baptist Hospital Hospital · Plant City, FL · CCN 100132

Procedures performed for Medicare patients

Medicare participation

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles (4 of 6)

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 6, 2024.

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1902880933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100910",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303844548",
            "telephone_number": "863-682-7246",
            "fax_number": "863-682-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015228",
            "telephone_number": "863-682-7246",
            "fax_number": "863-682-5566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "702 N Alexander St",
            "address_purpose": "LOCATION",
            "city": "Plant City",
            "state": "FL",
            "postal_code": "335633064",
            "country_code": "US",
            "telephone_number": "813-999-2000 x4",
            "fax_number": "813-501-1001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTERO",
        "first_name": "CARLOS",
        "middle_name": "ALBERTO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME72561",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "FL",
            "license": "ME72561",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME72561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "32989",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050077125",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

• Karen Joy Bosilovich, PT, ATC
• William Robert Bosley, MD
• William J Boss Jr.
• Fallon Charlinda Boston, APRN
• Andrew Bostrom, RMHCI
• Abigail Bott
• Ann Bottoms, CRNA
• Zachary Boucher, M.D.
• Jennifer Bourne, MD
• Jacob Boutros

All providers in Lakeland, FL · Interventional Pain Medicine Physician in Florida