Individual provider Active NPI

Mark B Weitzenfeld, MD

  • Urology Physician
  • Aventura, FL
National Provider Identifier
1316132137
Registry record updated Jun 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME27164 Issued in FL
Practice address
21110 Biscayne Blvd
Suite 401
Aventura, FL 33180-1227
Phone
(305) 933-1772
Fax
(305) 675-2788
NPI assigned
Sep 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME27164 FL Primary

Addresses

Primary practice location

21110 Biscayne Blvd
Suite 401
Aventura, FL 33180-1227

Mailing address

2234 Colonial Blvd
Attn: Payer Contracting & Relations Dept.
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other identifiers 15

IdentifierTypeStateIssuer
56089OtherFLBLUE CROSS BLUE SHIELD
56089OtherFLBCBS
P971396OtherFLOPTIMUM
002364OtherFLNHP
0366037OtherFLCIGNA
1256832OtherFLWELLCARE MEDICARE ONLY
P00284474OtherFLRAILROAD MEDICARE
1005619OtherFLCAREPLUS
4200786OtherFLAETNA
P1035626OtherFLFREEDOM
P0001582OtherFLSIMPLY
203827OtherFLAVMED
2364OtherFLDIMENSION
P01609935OtherFLRR MEDICARE
040323700MedicaidFL

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
I20060314000540 FL Practitioner - Urology 1951318005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Urology Partners LLPGroup PAC ID 2062574924, 66 clinicians

Practice addresses (Care Compare)

12408 N 56TH St
Suite 1
Temple Terrace, FL 33617-1522
Phone (813) 980-3104

7614 Jacque Rd
Suite a
Hudson, FL 34667-7195
Phone (727) 862-8548

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Florida Urology Partners, LLP Urology CurrentSince Sep 1, 2023 Accepting new patients
Florida Urology Partners LLP PastSince Nov 17, 2019 Accepting new patients
Genesiscare USA of Florida LLC Urology Past Accepting new patients
Mark Alagna MD PA Urology Past Accepting new patients
Tampa General Provider Network Inc Urology PastSince Jun 1, 2022 Accepting new patients
Dade Broward Urology LLC Urology Past Accepting new patients

Locations

7614 Jacque Rd
Ste A
Hudson, FL 34667
Phone (727) 862-8548

10441 Quality Dr
Ste 201
Spring Hill, FL 34609
Phone (352) 684-5567

11373 Cortez Blvd
Ste 209
Spring Hill, FL 34613
Phone (352) 596-0786

5015 W Nassau St
Tampa, FL 33607
Phone (813) 356-0196

12408 N 56th St
Ste 1
Temple Terrace, FL 33617
Phone (813) 980-3104

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mweitzenfeld296351@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496707200000",
    "number": "1316132137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "address_2": "ATTN: PAYER CONTRACTING & RELATIONS 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": "21110 BISCAYNE BLVD",
            "address_2": "SUITE 401",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801227",
            "telephone_number": "305-933-1772",
            "fax_number": "305-675-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITZENFELD",
        "first_name": "MARK",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-14",
        "last_updated": "2017-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME27164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "56089",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "56089",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "P971396",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "002364",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0366037",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE MEDICARE ONLY",
            "identifier": "1256832",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00284474",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREPLUS",
            "identifier": "1005619",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4200786",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM",
            "identifier": "P1035626",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIMPLY",
            "identifier": "P0001582",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "203827",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIMENSION",
            "identifier": "2364",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01609935",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040323700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.