NPIMap

Individual provider Active NPI

Michael E. Corea, MD

  • Urology Physician
  • Dedham, MA
National Provider Identifier
1104813641
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
274005 Issued in MA
Practice address
910 Washington St Ste 200
Dedham, MA 02026-6022
Phone
(781) 762-0471
Fax
(781) 762-8072
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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 274005 MA Primary

Addresses

Primary practice location

910 Washington St Ste 200
Dedham, MA 02026-6022

Mailing address

910 Washington St Ste 200
Dedham, MA 02026-6022
Phone (781) 762-0471

Other practice location 1

19 Bramble Bush Dr
Falmouth, MA 02540-2325
Phone (508) 540-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050811000149 FL Practitioner - Urology 4981633898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Wisconsin School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Urology Institute LLCGroup PAC ID 2163653585, 152 clinicians

Practice addresses (Care Compare)

500 W 11TH St
Panama City, FL 32401-6304
Phone (850) 785-8557

Hospital & facility affiliations

  • HCA Florida Gulf Coast Hospital Hospital, Panama City, FL, CCN 100242
  • Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026
  • Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Urology Institute, LLC Urology CurrentSince Sep 13, 2024 Accepting new patients
Advanced Urology Institute, LLC Urology CurrentSince Sep 13, 2024 Accepting new patients
Advanced Urology Institute LLC Urology Past Accepting new patients
Mercy Hospital Past Accepting new patients
Hematology Oncology Associates of Central Brevard Past Accepting new patients
Brevard Urology Associates PA Urology Past Accepting new patients
Health First Medical Group, LLC Past Accepting new patients

Locations

609 W Highland Blvd
Inverness, FL 34452
Phone (352) 726-9707

2900 S Highway 77
Lynn Haven, FL 32444
Phone (850) 481-1687

12109 County Road 103
Oxford, FL 34484
Phone (352) 205-8981

500 W 11th St
Panama City, FL 32401
Phone (850) 785-8557

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc41222_advuroswflorida

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1104813641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 WASHINGTON ST STE 200",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020266022",
            "telephone_number": "781-762-0471",
            "fax_number": "781-762-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WASHINGTON ST STE 200",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020266022",
            "telephone_number": "781-762-0471",
            "fax_number": "781-762-8072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Bramble Bush Dr",
            "address_purpose": "LOCATION",
            "city": "Falmouth",
            "state": "MA",
            "postal_code": "025402325",
            "country_code": "US",
            "telephone_number": "508-540-7555",
            "fax_number": "508-540-3008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COREA",
        "first_name": "MICHAEL",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "274005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

Verify at the official NPI Registry.