NPIMap

Organization Active NPI

Genesiscare USA of Florida LLC

  • Surgery Physician
  • Venice, FL
National Provider Identifier
1124304084
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
GENESISCARE USA OF FLORIDA LLC
Practice address
195 Center Rd
Suite B
Venice, FL 34285-5565
Phone
(941) 492-6227
Fax
(941) 493-6335
NPI assigned
Oct 24, 2011
Organization subpart
Yes
Parent organization
GENESISCARE USA INC.As reported in NPPES

Authorized official

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

Corporate family (same tax ID) 15

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

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

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
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
Tax ID family
Genesiscare USA of Florida LLC (72 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

NPPES NPI Registry

Primary practice location

195 Center Rd
Suite B
Venice, FL 34285-5565

Mailing address

2160 Colonial Blvd
Fort Myers, FL 33907-1410
Phone (239) 931-7342

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
CE7138OtherFLRAILROAD MEDICACRE

Other names 1

NPPES NPI Registry
  • Melinda B Hart MD Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 24, 2020.

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598227200000",
    "number": "1124304084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071410",
            "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": "195 CENTER RD",
            "address_2": "SUITE B",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342855565",
            "telephone_number": "941-492-6227",
            "fax_number": "941-493-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESISCARE USA OF FLORIDA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESISCARE USA INC.",
        "enumeration_date": "2011-10-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "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": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICACRE",
            "identifier": "CE7138",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melinda B Hart MD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Melinda B Hart MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.