Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ricardo Andre Declet-Bauzo, MD

Individual provider Diagnostic Radiology Physician · NPI 1588153647

Ricardo Andre Declet-Bauzo, MD is a Diagnostic Radiology in El Segundo, California. Qualified in 2019, 7 years ago. Practices with Henry County Memorial Hospital, a 152-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Florida and Indiana.

Years since qualifying
7
Licensed in
FL, IN
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2330 Utah Ave Ste 200
El Segundo, CA 90245-4817
Phone: (281) 766-0959
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1116 W Carmen St Apt 319, Tampa, FL 33606-1302 — (787) 608-2600
  • 1100 Reid Pkwy, Richmond, IN 47374-1157 — (765) 983-3264

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 166292 (FL)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 01097300A (IN)

Record details

NPI number1588153647
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 4, 2018
Last updated in NPPESApril 10, 2026
Certification dateApril 10, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Henry County Memorial Hospital — 152 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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