Individual provider Active NPI

James Yves Denis, MD

  • General Practice Physician
  • Mangonia Park, FL
National Provider Identifier
1235208133
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN250 Issued in FL
Practice address
1233 45TH St Ste B4
Mangonia Park, FL 33407-2162
Phone
(561) 250-0000
Fax
(561) 842-3612
NPI assigned
Nov 6, 2006
Last updated
Mar 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 16,495 PR
General Practice Physician 208D00000X ACN250 FL Primary

Addresses

Primary practice location

1233 45TH St Ste B4
Mangonia Park, FL 33407-2162

Mailing address

1233 45TH St Ste B4
Mangonia Park, FL 33407-2162
Phone (561) 250-0000

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
I20081231000493 FL Practitioner - General Practice 8527067354 Reassigns benefits to 1 organization
Practice locations: Mangonia Park, FL

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1233 45TH St
Suite B4
Mangonia Park, FL 33407-2162
Phone (561) 250-0000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16,495PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Medical Care Center IV, Inc. CurrentSince Dec 11, 2024 Accepting new patients

Locations

1233 45th St
Ste B4
Mangonia Park, FL 33407
Phone (561) 250-0000

11500 NW 7th Ave
North Miami, FL 33168
Phone (305) 751-1500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1235208133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 45TH ST STE B4",
            "city": "MANGONIA PARK",
            "state": "FL",
            "postal_code": "334072162",
            "telephone_number": "561-250-0000",
            "fax_number": "561-842-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 45TH ST STE B4",
            "city": "MANGONIA PARK",
            "state": "FL",
            "postal_code": "334072162",
            "telephone_number": "561-250-0000",
            "fax_number": "561-842-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENIS",
        "first_name": "JAMES",
        "middle_name": "YVES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16,495",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mangonia Park, FL

Sources for this page

Verify at the official NPI Registry.