Organization Active NPI

Genesiscare USA of Florida LLC

  • Urology Physician
  • Fort Myers, FL
National Provider Identifier
1053703454
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
GENESISCARE USA OF FLORIDA LLC
Doing business as
Urology Experts
Practice address
8931 Colonial Center Dr
Suite 100
Fort Myers, FL 33905-7809
Phone
(239) 226-2727
Fax
(239) 931-7385
NPI assigned
Feb 23, 2015
Organization subpart
Yes
Parent organization
GENESISCARE USA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Authorized official

Name
Dan Collins
Title
President
Phone
(239) 931-7275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

8931 Colonial Center Dr
Suite 100
Fort Myers, FL 33905-7809

Mailing address

2270 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other names 1

  • Urology Experts Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204000663 FL Part B Supplier - Clinic/Group Practice 9830082882 Receives reassigned benefits from 314 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1053703454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8931 COLONIAL CENTER DR",
            "address_2": "SUITE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057809",
            "telephone_number": "239-226-2727",
            "fax_number": "239-931-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESISCARE USA OF FLORIDA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESISCARE USA INC",
        "enumeration_date": "2015-02-23",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-931-7275"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Urology Experts",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Urology Experts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.