Individual provider Active NPI

Renan Wilding

  • Anesthesiologist Assistant
  • Aventura, FL
National Provider Identifier
1366966269
Registry record updated Aug 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
20900 Biscayne Blvd
Aventura, FL 33180-1407
Phone
(305) 682-7000
NPI assigned
Aug 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X Primary

Addresses

Primary practice location

20900 Biscayne Blvd
Aventura, FL 33180-1407

Mailing address

15915 SW 2ND St
Sunrise, FL 33326-2245
Phone (954) 980-8420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171220000307 FL Practitioner - Anesthesiology Assistant 6002174141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

20900 Biscayne Blvd
Miami, FL 33180-1407
Phone (305) 682-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc Current Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Nov 1, 2017 Accepting new patients
Sheridan Healthcorp Inc CurrentSince Nov 1, 2017 Accepting new patients

Locations

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501545600000",
    "number": "1366966269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15915 SW 2ND ST",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333262245",
            "telephone_number": "954-980-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20900 BISCAYNE BLVD",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801407",
            "telephone_number": "305-682-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDING",
        "first_name": "RENAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-01",
        "last_updated": "2017-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.