Active NPI
Genesiscare USA of Florida, LLC
- Urology Physician
- Hollywood, FL
National Provider Identifier
1144599440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- GENESISCARE USA OF FLORIDA, LLC
- Practice address
- 4030 Sheridan St
Suite C
Hollywood, FL 33021-3564 - Phone
- (954) 961-7500
- Fax
- (954) 964-8965
- NPI assigned
- Dec 16, 2011
- Organization subpart
- Yes
- Parent organization
- GENESISCARE USA INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ian Wong
- Title
- Cfo
- Phone
- (303) 249-7486
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
4030 Sheridan St
Suite C
Hollywood, FL 33021-3564
Mailing address
1419 SE 8TH Ter Ste 200
Cape Coral, FL 33990-3213
Phone (239) 931-7342
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CE9586 | Other | FL | RAILROAD MEDICARE |
Other names 1
- Masel Urology Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0277669 | Genesiscare USA of Florida, LLC | Certificate of waiver | Jan 29, 2028 |
National Provider Directory
National Provider DirectoryNetworks
- HealthSun Health Plans Network
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Medical Oncology Physician
- Deerfield Beach, FL
- NPI 1902895360
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323993600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762128000000",
"number": "1144599440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1419 SE 8TH TER STE 200",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339903213",
"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": "4030 SHERIDAN ST",
"address_2": "SUITE C",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330213564",
"telephone_number": "954-961-7500",
"fax_number": "954-964-8965"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GENESISCARE USA OF FLORIDA, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GENESISCARE USA INC.",
"enumeration_date": "2011-12-16",
"last_updated": "2025-11-03",
"certification_date": "2025-11-03",
"status": "A",
"authorized_official_last_name": "WONG",
"authorized_official_first_name": "IAN",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "303-249-7486"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CE9586",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Masel Urology Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.