Organization Active NPI

Genesiscare USA of Florida, LLC

  • Urology Physician
  • Hollywood, FL
National Provider Identifier
1144599440
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
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.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
CE9586OtherFLRAILROAD MEDICARE

Other names 1

  • Masel Urology Center Doing business as

Medicare participation

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

Enrollment records 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0277669Genesiscare USA of Florida, LLC4030 Sheridan St Ste C, Hollywood, FL 33021Certificate of waiverJan 29, 2028

National Provider Directory

National Provider Directory

Networks

  • 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.

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.

Verify at the official NPI Registry.