Organization Active NPI

Wellcare Med Group Corp

  • Neurology Physician
  • Miami Lakes, FL
National Provider Identifier
1235793357
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
WELLCARE MED GROUP CORP
Practice address
14261 Commerce Way Ste 203
Miami Lakes, FL 33016-1647
Phone
(305) 698-4000
Fax
(305) 698-4014
NPI assigned
Apr 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Authorized official

Name
Bashar A Mohsen, MDNPI 1114953650
Title
Owner
Phone
(305) 698-4000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

14261 Commerce Way Ste 203
Miami Lakes, FL 33016-1647

Mailing address

14261 Commerce Way Ste 203
Miami Lakes, FL 33016-1647
Phone (305) 698-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191113003287 FL Part B Supplier - Clinic/Group Practice 2466884416 Receives reassigned benefits from 3 practitioners
Practice locations: Miami Lakes, FL

National Provider Directory

National Provider Directory

Locations

14261 Commerce Way
Ste 203
Miami Lakes, FL 33016
Phone (305) 698-4000

14750 NW 77th Ct
Ste 106
Miami Lakes, FL 33016
Phone (305) 698-4000

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 5

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": "1556064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1235793357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14261 COMMERCE WAY STE 203",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161647",
            "telephone_number": "305-698-4000",
            "fax_number": "305-698-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14261 COMMERCE WAY STE 203",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161647",
            "telephone_number": "305-698-4000",
            "fax_number": "305-698-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE MED GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-24",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "MOHSEN",
        "authorized_official_first_name": "BASHAR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-698-4000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.