Individual provider Active NPI

Rony Porudominsky, MD

  • Gastroenterology Physician
  • Coral Springs, FL
National Provider Identifier
1639119506
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
56934 Issued in FL
Practice address
9750 NW 33Rd St
Suite 208
Coral Springs, FL 33065-4042
Phone
(954) 341-3699
Fax
(954) 341-3778
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 56934 FL Primary

Addresses

Primary practice location

9750 NW 33Rd St
Suite 208
Coral Springs, FL 33065-4042

Mailing address

5431 N University Dr
Coral Springs, FL 33067-4639
Phone (954) 344-2522

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
I20070219000700 FL Practitioner - Gastroenterology 4688675523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastro Health, LLCGroup PAC ID 2365440567, 246 clinicians

Practice addresses (Care Compare)

3661 S Miami Ave
Miami, FL 33133-4214
Phone (305) 856-7333

4675 Linton Blvd
Delray Beach, FL 33445-6615

9750 NW 33Rd St
Suite 208
Coral Springs, FL 33065-4081
Phone (954) 341-3699

Merit-based Incentive Payment System (MIPS)

Final score
82.04 of 100Reported as group
Quality
65.4
Promoting interoperability
98
Improvement activities
40
Cost
76.41

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy18
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56934FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro Health, LLC Gastroenterology CurrentSince Mar 2, 2020 Accepting new patients
Gastro Health LLC Gastroenterology CurrentSince Mar 2, 2020 Accepting new patients
Galloway Anesthesia Associates LLC Past Accepting new patients

Locations

9750 NW 33rd St
Ste 208
Coral Springs, FL 33065
Phone (954) 341-3699

4675 Linton Blvd
Ste 202
Delray Beach, FL 33445
Phone (561) 495-5700

3661 S Miami Ave
Ste 907
Miami, FL 33133
Phone (305) 856-7333

7243 Della Dr
Orlando, FL 32819
Phone (407) 381-7366

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rony.porudominsky@gastrohealth.eclinicaldirectplus.com

Organizations & group practices 3

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1639119506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5431 N UNIVERSITY DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330674639",
            "telephone_number": "954-344-2522",
            "fax_number": "954-344-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9750 NW 33RD ST",
            "address_2": "SUITE 208",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654042",
            "telephone_number": "954-341-3699",
            "fax_number": "954-341-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORUDOMINSKY",
        "first_name": "RONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "56934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.