Individual provider Active NPI

Vitra Gosine, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Pembroke Pines, FL
National Provider Identifier
1376736181
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME99887 Issued in FL
Practice address
17901 NW 5TH Street
Suite #103
Pembroke Pines, FL 33029
Phone
(954) 538-0022
Fax
(954) 538-0028
NPI assigned
Aug 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME99887 FL Primary

Addresses

Primary practice location

17901 NW 5TH Street
Suite #103
Pembroke Pines, FL 33029

Mailing address

17901 NW 5TH Street
Suite #103
Pembroke Pines, FL 33029
Phone (954) 538-0022

Other identifiers 1

IdentifierTypeStateIssuer
AK820YOtherFLMEDICARE PTAN

Other names 1

  • Dr. Vitra Gosine Professional name

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
I20080724000361 FL Practitioner - Endocrinology 3678646676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
University of South Florida College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

17900 NW 5TH St
Suite 202
Pembroke Pines, FL 33029-2809

Hospital & facility affiliations

  • Memorial Hospital Pembroke Hospital, Pembroke Pines, FL, CCN 100230
  • Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME99887FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Integrative & Functional Endocrinology LLC Endocrinology, Diabetes & Metabolism CurrentSince Dec 23, 2019 Accepting new patients

Locations

17900 NW 5th St
Ste 202
Pembroke Pines, FL 33029
Phone (954) 800-1408

Interoperability endpoints

  • Direct secure messaging: vgosine12887@mhsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/HIBJBD/Endpoint/HIBJBD

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 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": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1376736181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17901 NW 5TH STREET",
            "address_2": "SUITE #103",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33029",
            "telephone_number": "954-538-0022",
            "fax_number": "954-538-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 NW 5TH STREET",
            "address_2": "SUITE #103",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33029",
            "telephone_number": "954-538-0022",
            "fax_number": "954-538-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSINE",
        "first_name": "VITRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-24",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME99887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AK820Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VITRA",
            "last_name": "GOSINE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.