Blueshine Medical Center LLC
NPI 1053138099ActiveOrganization· General Practice· Cape Coral, FL
General Practice in Cape Coral, Florida, registered in NPPES in September 2024. The authorized official on file is Jose Gustavo Cevallos, MD, Provider. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1053138099 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 23, 2024 |
| Last updated in NPPES | Sep 23, 2024 |
| Certified by provider | Sep 22, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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