Individual provider Active NPI

Michael Maurice Koonin, M.D.

  • Orthopaedic Surgery Physician
  • Miami, FL
National Provider Identifier
1306930532
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
0038049 Issued in FL
Practice address
21000 NE 28TH Ave Ste 104
Miami, FL 33180-1421
Phone
(305) 937-1999
Fax
(305) 931-9741
NPI assigned
Oct 3, 2006
Last updated
Apr 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 0038049 FL Primary

Addresses

Primary practice location

21000 NE 28TH Ave Ste 104
Miami, FL 33180-1421

Mailing address

21000 NE 28TH Ave Ste 104
Miami, FL 33180-1421
Phone (305) 937-1999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0038049FLMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Med Diagnostic Rehab of South Florida Inc Past Accepting new patients

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1306930532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21000 NE 28TH AVE STE 104",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331801421",
            "telephone_number": "305-937-1999",
            "fax_number": "305-931-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 NE 28TH AVE STE 104",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331801421",
            "telephone_number": "305-937-1999",
            "fax_number": "305-931-9741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONIN",
        "first_name": "MICHAEL",
        "middle_name": "MAURICE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "0038049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.