Individual provider Active NPI

Ronaldo A Calonje, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Tamarac, FL
National Provider Identifier
1104977362
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
ME95141 Issued in FL
Practice address
7401 N University Dr
Suite 206
Tamarac, FL 33321-2979
Phone
(954) 718-2230
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X ME95141 FL Primary

Addresses

Primary practice location

7401 N University Dr
Suite 206
Tamarac, FL 33321-2979

Mailing address

7401 N University Dr
Suite 206
Tamarac, FL 33321-2979
Phone (954) 718-2230

Other practice location 1

1375 E Schaumburg Rd
Suite 100
Schaumburg, IL 60194-5166
Phone (847) 891-6850

Other identifiers 1

IdentifierTypeStateIssuer
ME95141OtherFLFLORIDA MEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Tamarac Health Information Exchange (HIE)

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
I20060504000178 FL Practitioner - Family Practice 5395755391 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10139 NW 31St St
Suite 101
Coral Springs, FL 33065-3908
Phone (954) 718-2230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME95141FLMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pharmacy Familia LLC CurrentSince Sep 15, 2020 Accepting new patients
FB Health Solutions CurrentSince Sep 1, 2020 Accepting new patients
Holy Cross Urgent Care CurrentSince Feb 8, 2021 Accepting new patients
Solantic LLC Past Accepting new patients
Forest Drive Physicians PastSince Sep 1, 2020 Accepting new patients

Locations

3481 N University Dr
Coral Springs, FL 33065
Phone (954) 229-8634

1644 W Hillsboro Blvd
Deerfield Beach, FL 33442
Phone (561) 531-0713

450 W Hillsboro Blvd
Deerfield Beach, FL 33441
Phone (954) 429-9047

1115 S Federal Hwy
Ft Lauderdale, FL 33316
Phone (954) 764-6646

2501 E Hallandale Beach Blvd
Hallandale Beach, FL 33009
Phone (954) 932-0120

Organizations & group practices 6

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1104977362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 N UNIVERSITY DR",
            "address_2": "SUITE 206",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212979",
            "telephone_number": "954-718-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 N UNIVERSITY DR",
            "address_2": "SUITE 206",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212979",
            "telephone_number": "954-718-2230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1375 E Schaumburg Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601945166",
            "country_code": "US",
            "telephone_number": "847-891-6850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALONJE",
        "first_name": "RONALDO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME95141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICAL LICENSE",
            "identifier": "ME95141",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Tamarac",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7401 N University Dr",
            "address_2": "Suite 206",
            "city": "Tamarac",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333212979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

Verify at the official NPI Registry.