Individual provider Active NPI

Jose S Selem, M.D.

  • Anesthesiology Physician
  • Coral Gables, FL
National Provider Identifier
1003861469
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME 43828 Issued in FL
Practice address
814 Ponce de Leon Blvd
Ste 510
Coral Gables, FL 33134
Phone
(305) 444-0221
Fax
(305) 444-0223
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME 43828 FL Primary

Addresses

Primary practice location

814 Ponce de Leon Blvd
Ste 510
Coral Gables, FL 33134

Mailing address

1416 Castile Ave
Coral Gables, FL 33134
Phone (305) 720-8668

Other identifiers 1

IdentifierTypeStateIssuer
068561500MedicaidFL

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
I20050725000202 FL Practitioner - Anesthesiology 8325075161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

814 Ponce de Leon Blvd
Suite 510
Coral Gables, FL 33134-3035
Phone (305) 444-0221

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 43828FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jose Selem, M.D., P.a. Anesthesiology CurrentSince May 1, 2005 Accepting new patients

Locations

814 Ponce de Leon Blvd
Ste 510
Coral Gables, FL 33134
Phone (305) 444-0221

Interoperability endpoints

  • FHIR API: https://fhir.yourcareuniverse.net/tenant/15ccfc48-8123-499c-be14-3dda9ff453c2
  • FHIR API: https://fhir.yourcareuniverse.net/tenant/c9b51470-851c-4df8-9318-9ceb36fa9d81

Organizations & group practices 1

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1003861469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 CASTILE AVE",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "33134",
            "telephone_number": "305-720-8668",
            "fax_number": "305-444-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 PONCE DE LEON BLVD",
            "address_2": "STE 510",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "33134",
            "telephone_number": "305-444-0221",
            "fax_number": "305-444-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELEM",
        "first_name": "JOSE",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME 43828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068561500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.