Rodrigo A Bolanos, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

ME121741 Issued in FL

Practice address

200 Avenue F NE Ste 9118
Winter Haven, FL 33881-4131

Phone

(863) 297-1777

Fax

(863) 297-1756

NPI assigned

Sep 4, 2006

Last updated

Sep 6, 2024By 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 1

Addresses

Other identifiers 6

Electronic endpoints 1

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

Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)

Education

University of Miami, LM Miller School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052
• Adventhealth Sebring Hospital, Sebring, FL, CCN 100109

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: rodrigoa.bolanos@direct.mybaycare.org

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.

• Baycare Medical Group, Inc.

  • General Practice Physician
  • Clearwater, FL
  • NPI 1043269871

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Baycare Medical Group, Inc.

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1659720837
  NPD

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

• Adventist Health System-Sunbelt Inc

  dba AdventHealth Cancer Institute Sebring

  • General Acute Care Hospital
  • Sebring, FL
  • NPI 1083692594
  Care Compare affiliation
• Winter Haven Hospital Inc

  • General Acute Care Hospital
  • Winter Haven, FL
  • NPI 1477599975
  Care Compare affiliation

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1962504456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 AVENUE F NE STE 9118",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814131",
            "telephone_number": "863-292-4004",
            "fax_number": "863-292-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 AVENUE F NE STE 9118",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814131",
            "telephone_number": "863-297-1777",
            "fax_number": "863-297-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANOS",
        "first_name": "RODRIGO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-04",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME121741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013541400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST PROVIDER #",
            "identifier": "1962504456",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA MEDICAID",
            "identifier": "N0022E",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROV#",
            "identifier": "P00665200",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909815",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NC PROVIDER #",
            "identifier": "143NK",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RodrigoA.Bolanos@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew Street",
            "address_2": "East Bldg 2nd Floor",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• BM Medical Center, LLC
• Bobs Pharmacy & Diabetic Supplies
• Lena Rose Boccio, MA, CCC-SLP
• Victoria Bodaj, CRNA
• Henry Joseph Bohn, DNP, CRNA
• Bond Clinic PA
• Bond Clinic PA
• Bond Clinic PA
• Bond Clinic PA
• Bond Urgent Care LLC

• Cardiovascular Disease Physician in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.