Individual provider Active NPI

Fernando Bravo, MD

  • General Practice Physician
  • Arecibo, PR
National Provider Identifier
1912774985
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23753 Issued in PR
Practice address
Urb Los Aires Serenos 78 Calle Platino
Arecibo, PR 00612
Phone
(787) 218-6265
NPI assigned
Dec 8, 2023
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 23753 PR Primary

Addresses

Primary practice location

Urb Los Aires Serenos 78 Calle Platino
Arecibo, PR 00612

Mailing address

Urb Los Aires Serenos 78 Calle Platino
Arecibo, PR 00612
Phone (787) 218-6265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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

Enrollment IDStateProvider typePAC IDDetails
I20241024004470 PR Practitioner - General Practice 9537692850 Reassigns benefits to 1 organization
Practice locations: Arecibo, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Providers LLCGroup PAC ID 9436436706, 18 clinicians

Practice addresses (Care Compare)

55 Calle Palma
Arecibo, PR 00612-4526
Phone (787) 436-0727

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23753PRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Providers, LLC CurrentSince Sep 1, 2024 Accepting new patients
Platinum Emergency Physicians, PSC Past Accepting new patients

Locations

55 Calle Palma
Arecibo, PR 00612
Phone (787) 605-0374

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1912774985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB LOS AIRES SERENOS 78 CALLE PLATINO",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-218-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB LOS AIRES SERENOS 78 CALLE PLATINO",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-218-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "FERNANDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-08",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

Verify at the official NPI Registry.