Individual provider Active NPI

Elliot Dinetz, M.D.

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1134495997
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME128081 Issued in FL
Practice address
3661 S Miami Ave Ste 604
Miami, FL 33133-4248
Phone
(786) 490-5915
NPI assigned
Mar 27, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X ME128081 FL Primary

Addresses

Primary practice location

3661 S Miami Ave Ste 604
Miami, FL 33133-4248

Mailing address

3661 S Miami Ave Ste 604
Miami, FL 33133-4248
Phone (786) 490-5915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 1, 2024 through Apr 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME128081FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ann T Macintyre DO LLC PastSince Mar 31, 2024 Accepting new patients

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": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1134495997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3661 S MIAMI AVE STE 604",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334248",
            "telephone_number": "786-490-5915",
            "fax_number": "561-420-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 S MIAMI AVE STE 604",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334248",
            "telephone_number": "786-490-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINETZ",
        "first_name": "ELLIOT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-27",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME128081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.