NPIMap

Organization Active NPI

Novus Community Services, LLC

  • Community/Behavioral Health Agency
  • Miami, FL
National Provider Identifier
1376158485
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NOVUS COMMUNITY SERVICES, LLC
Practice address
9900 SW 107TH Ave Ste 101
Miami, FL 33176-2798
Phone
(305) 964-5381
Fax
(305) 489-8151
NPI assigned
Sep 15, 2020
Last updated
Mar 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Authorized official

Name
Rogelio Gonzalez
Title
Owner
Phone
(305) 964-5381

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

9900 SW 107TH Ave Ste 101
Miami, FL 33176-2798

Mailing address

23037 SW 108TH CT
Miami, FL 33170-7538
Phone (786) 302-0569

Other practice location 1

13335 SW 124th St Ste 115
Miami, FL 33186-7513
Phone (786) 302-0569

Other names 1

  • NOVUS Community Services, LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210708001559 FL Part B Supplier - Clinic/Group Practice 0749682102 Receives reassigned benefits from 2 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory
Tax ID family
Novus Community Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9900 SW 107th Ave
Ste 101
Miami, FL 33176
Phone (305) 964-5381

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1376158485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23037 SW 108TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331707538",
            "telephone_number": "786-302-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 SW 107TH AVE STE 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762798",
            "telephone_number": "305-964-5381",
            "fax_number": "305-489-8151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13335 SW 124th St Ste 115",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331867513",
            "country_code": "US",
            "telephone_number": "786-302-0569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOVUS COMMUNITY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-15",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ROGELIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-964-5381"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NOVUS Community Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "NOVUS Community Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Mar 23, 2021; 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.