Individual provider Active NPI

Adam Michael De Fazio, MD

  • Urology Physician
  • Miami, FL
National Provider Identifier
1366839573
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
144122 Issued in FL
Practice address
3400 Coral Way Ste 500
Miami, FL 33145-3053
Phone
(305) 603-8684
NPI assigned
Apr 25, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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 144122 FL Primary

Addresses

Primary practice location

3400 Coral Way Ste 500
Miami, FL 33145-3053

Mailing address

3400 Coral Way Ste 500
Miami, FL 33145-3053
Phone (305) 603-8684

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
I20200730003169 FL Practitioner - Urology 7810291671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Columbia University College of Physicians and Surgeons, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Urology Group, LLCGroup PAC ID 2264829837, 2 clinicians

Practice addresses (Care Compare)

3400 Coral Way
Suite 500
Miami, FL 33145-3053
Phone (305) 603-8684

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
144122FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premium Healthcare Holdings, LLLP CurrentSince Jan 1, 2024 Accepting new patients
Modern Urology Group LLC Urology CurrentSince Apr 1, 2022 Accepting new patients
Hoover Family Medicine PA PastSince Jan 1, 2024 Accepting new patients

Locations

2400 SW 69th Ave
Ste 100
Miami, FL 33155

3400 Coral Way
Ste 500
Miami, FL 33145
Phone (305) 603-8684

Interoperability endpoints

  • Direct secure messaging: adam.defazio@hca4.eclinicaldirectplus.com
  • Direct secure messaging: adam.defazio.1@26205.direct.athenahealth.com

Organizations & group practices 3

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.

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": "1429920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1366839573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CORAL WAY STE 500",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331453053",
            "telephone_number": "305-603-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CORAL WAY STE 500",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331453053",
            "telephone_number": "305-603-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE FAZIO",
        "first_name": "ADAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-25",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "144122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.