Individual provider Active NPI

Gerard Michael Cuomo, D.D.S

  • General Practice Dentistry
  • Boca Raton, FL
National Provider Identifier
1033253448
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 10019 Issued in FL
Practice address
900 NW 13TH St
Suite 300
Boca Raton, FL 33486-2335
Phone
(561) 391-6290
Fax
(561) 391-6299
NPI assigned
Feb 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 10019 FL Primary

Addresses

Primary practice location

900 NW 13TH St
Suite 300
Boca Raton, FL 33486-2335

Mailing address

17756 Oakwood Ave
Boca Raton, FL 33487-2211
Phone (561) 995-0790

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150605001353 FL Order and Referring Only - DentistPractitioner - Dentist 2163743816

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 10019FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242777600000",
    "number": "1033253448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17756 OAKWOOD AVE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334872211",
            "telephone_number": "561-995-0790",
            "fax_number": "561-995-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 NW 13TH ST",
            "address_2": "SUITE 300",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862335",
            "telephone_number": "561-391-6290",
            "fax_number": "561-391-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUOMO",
        "first_name": "GERARD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-18",
        "last_updated": "2009-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 10019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.