Individual provider Active NPI

Mauricio Danckers Degregori, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Boca Raton, FL
National Provider Identifier
1386956779
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
M121491 Issued in FL
Practice address
1875 NW Corporate Blvd Ste 270
Boca Raton, FL 33431-8550
Phone
(561) 997-0821
NPI assigned
Jul 14, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X M121491 FL Primary
Pulmonary Disease Physician 207RP1001X M121491 FL

Addresses

Primary practice location

1875 NW Corporate Blvd Ste 270
Boca Raton, FL 33431-8550

Mailing address

8310 SW 99TH Ave
Miami, FL 33173-4021
Phone (305) 484-2852

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
I20150902000448 FL Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 5991011124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine, Pulmonary Disease
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 276-8500

20900 Biscayne Blvd
Aventura, FL 33180-1407
Phone (561) 997-0821

Hospital & facility affiliations

  • HCA Florida Aventura Hospital Hospital, Aventura, FL, CCN 100131

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M121491FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intensive Care Consortium Inc Critical Care Medicine CurrentSince Mar 11, 2015 Accepting new patients

Locations

1875 NW Corporate Blvd
Ste 270
Boca Raton, FL 33431
Phone (561) 997-0849

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

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

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

11375 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 596-4209

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 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": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1386956779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8310 SW 99TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331734021",
            "telephone_number": "305-484-2852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 NW CORPORATE BLVD STE 270",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334318550",
            "telephone_number": "561-997-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANCKERS DEGREGORI",
        "first_name": "MAURICIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-14",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "M121491",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "M121491",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.