Individual provider Active NPI

Jose Luis Vilaro Valderrabano, MD

  • Urology Physician
  • Miami, FL
National Provider Identifier
1093127631
Registry record updated Mar 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME144463 Issued in FL
Practice address
9920 SW 40TH St
Miami, FL 33165-3944
Phone
(786) 360-4425
Fax
(786) 360-4461
NPI assigned
Jun 2, 2014
Last updated
Mar 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME144463 FL Primary

Addresses

Primary practice location

9920 SW 40TH St
Miami, FL 33165-3944

Mailing address

3641 S Miami Ave Ste 170
Miami, FL 33133-4219
Phone (305) 285-2767

Other practice location 1

3641 S Miami Ave Ste 170
Miami, FL 33133-4219
Phone (305) 285-2767

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
I20200811003251 FL Practitioner - Urology 6406192822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Urology Group, LLCGroup PAC ID 2264829837, 2 clinicians

Practice addresses (Care Compare)

3400 Coral Way
Suite 500
Miami, FL 33145-3053
Phone (305) 603-8684

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME144463FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Urology Group LLC Urology CurrentSince Apr 1, 2022 Accepting new patients
Premium Healthcare Holdings, LLLP CurrentSince Jan 1, 2024 Accepting new patients
Hoover Family Medicine PA PastSince Jan 1, 2024 Accepting new patients

Locations

2400 SW 69th Ave
Ste 100
Miami, FL 33155

3400 Coral Way
Ste 500
Miami, FL 33145
Phone (305) 603-8684

9920 SW 40th St
Miami, FL 33165
Phone (786) 360-4425

Interoperability endpoints

  • Direct secure messaging: jose.valderrabanio@hca4.eclinicaldirectplus.com
  • Direct secure messaging: jose.vilarovalderrabano.1@26205.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647734400000",
    "number": "1093127631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3641 S MIAMI AVE STE 170",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334219",
            "telephone_number": "305-285-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9920 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653944",
            "telephone_number": "786-360-4425",
            "fax_number": "786-360-4461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3641 S Miami Ave Ste 170",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331334219",
            "country_code": "US",
            "telephone_number": "305-285-2767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILARO VALDERRABANO",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-02",
        "last_updated": "2022-03-20",
        "certification_date": "2022-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME144463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.