Individual provider Active NPI

Raul Javier Vargas Rivera, MD

  • General Practice Physician
  • Winter Haven, FL
National Provider Identifier
1962098749
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1361 Issued in FL
Practice address
217 E Central Ave
Winter Haven, FL 33880-6312
Phone
(407) 315-3637
Fax
(407) 358-3440
NPI assigned
Dec 16, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MED-PHYS-REG-0002152 MT
General Practice Physician 208D00000X TPME1150 FL
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X TPPA107 FL
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X ACN1361 FL Primary

Addresses

Primary practice location

217 E Central Ave
Winter Haven, FL 33880-6312

Mailing address

PO Box 532
Lake Alfred, FL 33850-0532
Phone (407) 315-3637

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
I20210212001883 FL Practitioner - General Practice 3779998315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

304 E Pine St
Suite 1018
Lakeland, FL 33801-4969
Phone (407) 315-3637

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN1361FLMDGeneral Practice Physician
MED-PHYS-REG-0002152MTMDGeneral Practice Physician
TPPA107FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
We Care Family Physicians LLC Single Specialty CurrentSince Nov 1, 2020 Accepting new patients
We Care Specialty Physicians LLC Single Specialty PastSince Dec 27, 2020 Accepting new patients

Locations

304 E Pine St
Lakeland, FL 33801
Phone (407) 315-3637

217 E Central Ave
Winter Haven, FL 33880
Phone (407) 315-3637

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1962098749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 532",
            "city": "LAKE ALFRED",
            "state": "FL",
            "postal_code": "338500532",
            "telephone_number": "407-315-3637",
            "fax_number": "407-358-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E CENTRAL AVE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338806312",
            "telephone_number": "407-315-3637",
            "fax_number": "407-358-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS RIVERA",
        "first_name": "RAUL",
        "middle_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-16",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MT",
            "license": "MED-PHYS-REG-0002152",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "TPME1150",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "TPPA107",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.