NPIMap

Organization Active NPI

Nova Gastro Group LLC

  • Gastroenterology Physician
  • Miami, FL
National Provider Identifier
1124815196
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
NOVA GASTRO GROUP LLC
Practice address
8260 W Flagler St Ste 1a
Miami, FL 33144-2069
Phone
(786) 715-9183
Fax
(786) 715-9183
NPI assigned
Apr 23, 2025
Last updated
Apr 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Authorized official

Name
Dr. Ivan Dario Canas Jr., DNP, MBANPI 1366066649
Title
Ceo
Phone
(786) 715-9183

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

8260 W Flagler St Ste 1a
Miami, FL 33144-2069

Mailing address

11420 N Kendall Dr Ste 207
Miami, FL 33176-1039
Phone (786) 715-9183

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250729002230 FL Part B Supplier - Clinic/Group Practice 8729595251 Receives reassigned benefits from 9 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1124815196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11420 N KENDALL DR STE 207",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761039",
            "telephone_number": "786-715-9183",
            "fax_number": "786-713-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8260 W FLAGLER ST STE 1A",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442069",
            "telephone_number": "786-715-9183",
            "fax_number": "786-715-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA GASTRO GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "CANAS",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "DARIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-715-9183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DNP, MBA"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.