Individual provider Active NPI

Genaro Antonio Marcial Nieves, MD

  • General Practice Physician
  • Sunrise, FL
National Provider Identifier
1497409643
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
24082 Issued in PR
Practice address
8890 W Oakland Park Blvd Ste 100
Sunrise, FL 33351-7223
Phone
(954) 741-3304
Fax
(754) 222-6417
NPI assigned
Feb 7, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 24082 PR Primary

Addresses

Primary practice location

8890 W Oakland Park Blvd Ste 100
Sunrise, FL 33351-7223

Mailing address

PO Box 250579
Aguadilla, PR 00604-0579
Phone (787) 223-7924

Other practice location 1

Calle Concepcion Vera Ayala
Moca, PR 00676
Phone (787) 877-8000

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
I20250404001371 FL Practitioner - General Practice 0547784167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvey S. Kleiner DO, LLCGroup PAC ID 1355523879, 10 clinicians

Practice addresses (Care Compare)

8890 W Oakland Park Blvd
Suite 100
Sunrise, FL 33351-7223
Phone (954) 741-3304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24082PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infinity Healthcare Medical LLC CurrentSince Mar 1, 2025 Accepting new patients
Harvey S. Kleiner DO, LLC General Practice CurrentSince Mar 31, 2025 Accepting new patients

Locations

1008 Virginia Ave
Fort Pierce, FL 34982
Phone (772) 460-6767

1803 S 25th St
Ste 4
Fort Pierce, FL 34947
Phone (772) 666-1801

2730 N State Road 7
Margate, FL 33063
Phone (561) 688-8917

1226 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (772) 337-7800

8890 W Oakland Park Blvd
Ste 200
Sunrise, FL 33351
Phone (954) 741-3304

8890 W Oakland Park Blvd
Ste 100
Sunrise, FL 33351
Phone (954) 228-2322

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1497409643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250579",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006040579",
            "telephone_number": "787-223-7924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8890 W OAKLAND PARK BLVD STE 100",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333517223",
            "telephone_number": "954-741-3304",
            "fax_number": "754-222-6417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Calle Concepcion Vera Ayala",
            "address_purpose": "LOCATION",
            "city": "Moca",
            "state": "PR",
            "postal_code": "00676",
            "country_code": "US",
            "telephone_number": "787-877-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCIAL NIEVES",
        "first_name": "GENARO",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-07",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "24082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

Verify at the official NPI Registry.