Individual provider Active NPI

Oscar Loret de Mola, MD

  • Pediatric Gastroenterology Physician
  • Miami, FL
National Provider Identifier
1215994447
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
ME41693 Issued in FL
Practice address
7775 SW 87TH Ave
120
Miami, FL 33173-2536
Phone
(305) 274-8243
Fax
(305) 274-8482
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X ME41693 FL Primary

Addresses

Primary practice location

7775 SW 87TH Ave
120
Miami, FL 33173-2536

Mailing address

7775 SW 87TH Ave
120
Miami, FL 33173-2536
Phone (305) 274-8243

Other identifiers 1

IdentifierTypeStateIssuer
045856200MedicaidFL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070822000955 FL Practitioner - Pediatric MedicinePractitioner - Gastroenterology 7012009012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Gastroenterology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miami Pediatric Gastroenterology LLCGroup PAC ID 2365705217, 2 clinicians

Practice addresses (Care Compare)

7775 SW 87TH Ave
Suite 120
Miami, FL 33173-2536
Phone (305) 274-8243

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME41693FLMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Miami Pediatric Gastroenterology LLC CurrentSince Sep 25, 2017 Accepting new patients

Locations

8525 SW 92nd St
Ste C11A
Miami, FL 33156
Phone (305) 512-3345

7775 SW 87th Ave
Ste 120
Miami, FL 33173
Phone (305) 274-8243

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1215994447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7775 SW 87TH AVE",
            "address_2": "120",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331732536",
            "telephone_number": "305-274-8243",
            "fax_number": "305-274-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7775 SW 87TH AVE",
            "address_2": "120",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331732536",
            "telephone_number": "305-274-8243",
            "fax_number": "305-274-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORET DE MOLA",
        "first_name": "OSCAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME41693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045856200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.