Individual provider Active NPI

Raul P Palomado, M.D

  • General Practice Physician
  • Bowling Green, FL
National Provider Identifier
1922043439
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME 49281 Issued in FL
Practice address
302 W Main St
Bowling Green, FL 33834-5053
Phone
(863) 375-2214
Fax
(863) 375-2212
NPI assigned
Jun 18, 2006
Last updated
Mar 21, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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 ME 49281 FL Primary

Addresses

Primary practice location

302 W Main St
Bowling Green, FL 33834-5053

Mailing address

302 W Main St
PO Box 1357
Bowling Green, FL 33834-5053
Phone (863) 375-2214

Other identifiers 1

IdentifierTypeStateIssuer
039232400MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120131000847 FL Practitioner - General Practice 8325125362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

302 W Main St
Bowling Green, FL 33834-5053
Phone (863) 375-2214

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 49281FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Raul P. Palomado, MD PA CurrentSince Sep 9, 1986 Accepting new patients
Major Hospital Past Accepting new patients

Locations

302 W Main St
Bowling Green, FL 33834
Phone (813) 375-2214

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 2

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1922043439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W MAIN ST",
            "address_2": "PO BOX 1357",
            "city": "BOWLING GREEN",
            "state": "FL",
            "postal_code": "338345053",
            "telephone_number": "863-375-2214",
            "fax_number": "863-375-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W MAIN ST",
            "city": "BOWLING GREEN",
            "state": "FL",
            "postal_code": "338345053",
            "telephone_number": "863-375-2214",
            "fax_number": "863-375-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOMADO",
        "first_name": "RAUL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME 49281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039232400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, FL

Sources for this page

Verify at the official NPI Registry.