Individual provider Active NPI

Anselmo Humberto Humaran, MD

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1114038023
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME41680 Issued in FL
Practice address
11474 Quail Roost Dr
Miami, FL 33157-6575
Phone
(305) 232-2066
Fax
(305) 232-2089
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME41680 FL Primary

Addresses

Primary practice location

11474 Quail Roost Dr
Miami, FL 33157-6575

Mailing address

11474 Quail Roost Dr
Miami, FL 33157-6575
Phone (305) 232-2066

Other identifiers 2

IdentifierTypeStateIssuer
067320000MedicaidFL
96178OtherFLMEDICARE ID

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
I20101112000140 FL Practitioner - General Practice 3870788185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11474 Quail Roost Dr
Miami, FL 33157-6575
Phone (305) 232-2066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME41680FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anselmo H. Humaran MD,PA General Practice CurrentSince Jun 7, 2010 Accepting new patients

Locations

11474 Quail Roost Dr
Miami, FL 33157
Phone (305) 232-2066

Organizations & group practices 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1114038023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11474 QUAIL ROOST DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331576575",
            "telephone_number": "305-232-2066",
            "fax_number": "305-232-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11474 QUAIL ROOST DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331576575",
            "telephone_number": "305-232-2066",
            "fax_number": "305-232-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMARAN",
        "first_name": "ANSELMO",
        "middle_name": "HUMBERTO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME41680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067320000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "96178",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.