Individual provider Active NPI

David Jesse Gerth Jr., M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Miami, FL
National Provider Identifier
1649475583
Registry record updated May 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
ME117335 Issued in FL
Practice address
1120 NW 14TH St
CRB 4TH FL
Miami, FL 33136-2107
Phone
(305) 243-4500
NPI assigned
Jun 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X 25MA09108500 NJ
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X ME117335 FL Primary

Addresses

Primary practice location

1120 NW 14TH St
CRB 4TH FL
Miami, FL 33136-2107

Mailing address

300 S Biscayne Blvd
Apt 3211
Miami, FL 33131-5312
Phone (901) 283-7691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20180430000217 NH Practitioner - Otolaryngology 6507120540 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09108500NJMDFacial Plastic Surgery Physician
ME117335FLMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Mar 30, 2018 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Mar 30, 2018 Accepting new patients

Locations

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

361 High St
Somersworth, NH 03878
Phone (603) 692-4500

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": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462665600000",
    "number": "1649475583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S BISCAYNE BLVD",
            "address_2": "APT 3211",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331315312",
            "telephone_number": "901-283-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 NW 14TH ST",
            "address_2": "CRB 4TH FL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331362107",
            "telephone_number": "305-243-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERTH",
        "first_name": "DAVID",
        "middle_name": "JESSE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2016-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NJ",
            "license": "25MA09108500",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "FL",
            "license": "ME117335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.