Active NPI
Marc C. Gittelman, M.D.
- Urology Physician
- Aventura, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- ME53015
- Practice address
- 21150 Biscayne Blvd
Suite 404
Aventura, FL 33180-1226 - Phone
- (305) 466-9111
- Fax
- (305) 466-9127
- NPI assigned
- Apr 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | ME53015 | FL | |
| Urology Physician | 208800000X | ME53015 | FL | Primary |
Addresses
Primary practice location
21150 Biscayne Blvd
Suite 404
Aventura, FL 33180-1226
Mailing address
2234 Colonial Blvd
Managed Care Dept
Fort Myers, FL 33907-1412
Phone (239) 931-7342
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001601400 | Medicaid | FL | |
| 05776 | Other | FL | BCBS FL |
| P0003164 | Other | FL | FLORIDA HEALTHCARE PLUS |
| 4068398 | Other | FL | AETNA PROVIDER # |
| P00721039 | Other | FL | RR MEDICARE |
| QMP000004462340 | Other | FL | MOLINA |
| 1193060 | Other | FL | WELLCARE |
| P01730303 | Other | FL | SIMPLY HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Icahn School of Medicine at Mount Sinai, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1419 SE 8TH Ter
Cape Coral, FL 33990-3213
Phone (239) 772-3202
21150 Biscayne Blvd
Suite 104
Aventura, FL 33180-1231
Phone (305) 535-2170
2801 NE 213TH St
1001 Uro Medix
Aventura, FL 33180-1265
Phone (305) 466-9111
603 N Flamingo Rd
Suite 251
Pembroke Pines, FL 33028-1013
Phone (954) 430-5200
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.45 of 100
- Promoting interoperability
- 97
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME53015 | FL | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesiscare USA of Florida LLC | Urology | Current | Accepting new patients |
| Genesiscare USA of Florida LLC | Urology | Current | Accepting new patients |
| Genesiscare USA of Florida LLC | Urology | Current | Accepting new patients |
Locations
2801 NE 213th St
Ste 1001
Aventura, FL 33180
Phone (305) 466-9111
1419 SE 8th Ter
Cape Coral, FL 33990
Phone (239) 772-3202
2160 Colonial Blvd
Fort Myers, FL 33907
2234 Colonial Blvd
Fort Myers, FL 33907
Phone (239) 931-7212
7150 W 20th Ave
Hialeah, FL 33016
Phone (305) 558-4035
7100 W 20th Ave
Ste G154
Hialeah, FL 33016
Phone (305) 558-6518
21150 Biscayne Blvd
Ste 104
Miami, FL 33180
Phone (305) 535-2170
21150 Biscayne Blvd
Ste 404
Miami, FL 33180
Phone (305) 466-9111
730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119
603 N Flamingo Rd
Ste 251
Pembroke Pnes, FL 33028
Phone (954) 430-3999
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Organizations & group practices 3
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.
-
- Urology Physician
- Lake Worth, FL
- NPI 1184095234
-
- Urology Physician
- Boca Raton, FL
- NPI 1649093709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491782400000",
"number": "1174587604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2234 COLONIAL BLVD",
"address_2": "MANAGED CARE DEPT",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339071412",
"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": "21150 BISCAYNE BLVD",
"address_2": "SUITE 404",
"city": "AVENTURA",
"state": "FL",
"postal_code": "331801226",
"telephone_number": "305-466-9111",
"fax_number": "305-466-9127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GITTELMAN",
"first_name": "MARC",
"middle_name": "C.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-13",
"last_updated": "2017-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "ME53015",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "FL",
"license": "ME53015",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001601400",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FL",
"identifier": "05776",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA HEALTHCARE PLUS",
"identifier": "P0003164",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER #",
"identifier": "4068398",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00721039",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA",
"identifier": "QMP000004462340",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "1193060",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SIMPLY HEALTHCARE",
"identifier": "P01730303",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Aventura, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.