Individual provider Active NPI

Hendrik Dinkla, ME53372

  • Neurology Physician
  • Port Saint Lucie, FL
National Provider Identifier
1407899560
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME53372 Issued in FL
Practice address
10050 SW Innovation Way Suite 102
10050 SW Innovation Way Suite 102
Port Saint Lucie, FL 34987
Phone
(772) 344-3811
Fax
(772) 335-2422
NPI assigned
Jun 14, 2006
Last updated
Oct 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME53372 FL Primary

Addresses

Primary practice location

10050 SW Innovation Way Suite 102
10050 SW Innovation Way Suite 102
Port Saint Lucie, FL 34987

Mailing address

10050 SW Innovation Way Suite 102
10050 SW Innovation Way Suite 102
Port Saint Lucie, FL 34987
Phone (772) 344-3811

Other identifiers 1

IdentifierTypeStateIssuer
0447625-00MedicaidFL

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
I20110307000235 FL Practitioner - Neurology 3173422664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Miami, LM Miller School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10000 SW Innovation Way
Port Saint Lucie, FL 34987-2111
Phone (772) 345-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Memorial Medical Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Memorial Hospital-West Volusia Inc Past Accepting new patients
Southwest Volusia Healthcare Corporation Neurology Past Accepting new patients

Locations

10000 SW Innovation Way
Port St Lucie, FL 34987
Phone (772) 288-5853

10050 SW Innovation Way
Ste 102
Port St Lucie, FL 34987
Phone (772) 288-5862

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: hdinkla2500999@direct.ccf.org

Organizations & group practices 4

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1407899560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10050 SW INNOVATION WAY SUITE 102",
            "address_2": "10050 SW INNOVATION WAY SUITE 102",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "34987",
            "telephone_number": "772-344-3811",
            "fax_number": "772-335-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10050 SW INNOVATION WAY SUITE 102",
            "address_2": "10050 SW INNOVATION WAY SUITE 102",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "34987",
            "telephone_number": "772-344-3811",
            "fax_number": "772-335-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINKLA",
        "first_name": "HENDRIK",
        "name_prefix": "Dr.",
        "credential": "ME53372",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME53372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0447625-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.