NPIMap

Organization Active NPI

Genesiscare USA of Florida LLC

Doing business as Graduate Surgical

  • Surgery Physician
  • West Palm Beach, FL
National Provider Identifier
1689043523
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
GENESISCARE USA OF FLORIDA LLC
Doing business as
Graduate Surgical
Practice address
1201 N Olive Ave
West Palm Beach, FL 33401-3515
Phone
(561) 655-4334
Fax
(561) 655-9449
NPI assigned
Sep 22, 2015
Last updated
Aug 25, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
GENESISCARE USA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Authorized official

Name
Dan Collins
Title
President
Phone
(239) 931-7275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1201 N Olive Ave
West Palm Beach, FL 33401-3515

Mailing address

2234 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 391-7342

Other names 1

  • Graduate Surgical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204000663 FL Part B Supplier - Clinic/Group Practice 9830082882 Receives reassigned benefits from 314 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
James W Orr Jr MD72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1689043523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-391-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N OLIVE AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013515",
            "telephone_number": "561-655-4334",
            "fax_number": "561-655-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESISCARE USA OF FLORIDA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESISCARE USA INC",
        "enumeration_date": "2015-09-22",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-931-7275"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Graduate Surgical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Graduate Surgical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.