Individual provider Active NPI

Gelenis Calzadilla Domingo, M.D.

  • Hematology & Oncology Physician
  • Aventura, FL
National Provider Identifier
1558534545
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME110846 Issued in FL
Practice address
20801 Biscayne Boulevard
Suite 200
Aventura, FL 33180-1422
Phone
(954) 265-4325
Fax
(305) 935-3186
NPI assigned
Apr 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X ME110846 FL Primary

Addresses

Primary practice location

20801 Biscayne Boulevard
Suite 200
Aventura, FL 33180-1422

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5644

Other identifiers 1

IdentifierTypeStateIssuer
004108900MedicaidFL

Other names 1

  • Gelenis Calzadilla Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gdomingo149676@MHSDIRECT.NET Direct

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
I20111128000745 FL Practitioner - Hematology/OncologyPractitioner - Internal Medicine 8426222621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
University of South Florida College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

20801 Biscayne Blvd
Suite 200
Aventura, FL 33180-1422
Phone (954) 265-4325

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME110846FLMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Aug 1, 2016 Accepting new patients
South Broward Hospital District Hematology & Oncology CurrentSince Aug 1, 2016 Accepting new patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

20950 NE 27th Ct
Ste 203
Aventura, FL 33180
Phone (305) 933-6545

20801 Biscayne Blvd
Ste 200
Aventura, FL 33180
Phone (954) 265-3015

1150 N 35th Ave
Ste 170
Hollywood, FL 33021
Phone (954) 985-1500

1150 N 35th Ave
Ste 330
Hollywood, FL 33021
Phone (954) 961-1500

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

12235 Pines Blvd
Pembroke Pines, FL 33026
Phone (954) 265-1125

Interoperability endpoints

  • Direct secure messaging: gdomingo149676@mhsdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1558534545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5644",
            "fax_number": "954-276-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20801 BISCAYNE BOULEVARD",
            "address_2": "SUITE 200",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801422",
            "telephone_number": "954-265-4325",
            "fax_number": "305-935-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "GELENIS",
        "middle_name": "CALZADILLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME110846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004108900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gdomingo149676@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "20801 Biscayne Boulevard",
            "address_2": "Suite 200",
            "city": "Aventura",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331801422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GELENIS",
            "last_name": "CALZADILLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.