Organization Active NPI

Mario Magcalas MD PA

  • Pulmonary Disease Physician
  • Pembroke Pines, FL
National Provider Identifier
1497856058
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
MARIO MAGCALAS MD PA
Practice address
10794 Pines Blvd
Suite 205
Pembroke Pines, FL 33026-3920
Phone
(954) 538-8543
Fax
(954) 431-8153
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Authorized official

Name
Jame Madali
Title
Administrator
Phone
(954) 538-8543

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

10794 Pines Blvd
Suite 205
Pembroke Pines, FL 33026-3920

Mailing address

10794 Pines Blvd
Suite 205
Pembroke Pines, FL 33026-3920
Phone (954) 538-8543

Other identifiers 1

IdentifierTypeStateIssuer
117970000MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070609000003 FL Part B Supplier - Clinic/Group Practice 4183722424 Receives reassigned benefits from 6 practitioners
Practice locations: Pembroke Pines, FL; Hollywood, FL; Miramar, FL; Miami, FL; Aventura, FL; Hialeah, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1078766Mario Magcalas MD PA10794 Pines Blvd Ste 205, Pembroke Pines, FL 33026Certificate of waiverJan 15, 2028

National Provider Directory

National Provider Directory

Locations

7150 W 20th Ave
Ste 216
Hialeah, FL 33016
Phone (305) 813-1820

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1497856058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10794 PINES BLVD",
            "address_2": "SUITE 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263920",
            "telephone_number": "954-538-8543",
            "fax_number": "954-431-8153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10794 PINES BLVD",
            "address_2": "SUITE 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263920",
            "telephone_number": "954-538-8543",
            "fax_number": "954-431-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIO MAGCALAS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "MADALI",
        "authorized_official_first_name": "JAME",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-538-8543"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117970000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.