Individual provider Active NPI

Anesa W Ahamad, M.D.

  • Radiation Oncology Physician
  • Aventura, FL
National Provider Identifier
1710083506
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ME89438 Issued in FL
Practice address
21355 E Dixie Hwy Ste 111
Aventura, FL 33180
Phone
(305) 692-1100
Fax
(305) 692-1111
NPI assigned
Sep 16, 2006
Last updated
Jul 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X L8584 TX
Radiation Oncology Physician 2085R0001X ME89438 FL Primary

Addresses

Primary practice location

21355 E Dixie Hwy Ste 111
Aventura, FL 33180

Mailing address

2160 Colonial Blvd
Fort Myers, FL 33907-1410
Phone (239) 931-7342

Other practice location 1

3426 N Roosevelt Blvd
Key West, FL 33040-4224
Phone (305) 296-0021

Other practice location 2

5555 Ponce De Leon Blvd
Coral Gables, FL 33146-2513
Phone (305) 689-5555

Other practice location 3

5555 Ponce De Leon Blvd
Coral Gables, FL 33146-2513
Phone (305) 689-5555

Other identifiers 8

IdentifierTypeStateIssuer
7490640OtherFLAETNA THRU KEYS PHA
1052055OtherFLCIGNA
14C0HOtherFLBCBS FL
158343701MedicaidTX
346218OtherFLAVMED
789645OtherFLWELLCARE
P00921457OtherFLRAILROAD MEDICARE
003252000MedicaidFL

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
I20110330000503 FL Practitioner - Radiation Oncology 0749463693 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L8584TXMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Jan 1, 2020 Accepting new patients
Genesiscare USA of Florida LLC Past Accepting new patients
Genesiscare USA of Florida LLC PastSince Jul 28, 2019 Accepting new patients

Locations

5555 Ponce de Leon Blvd
Coral Gables, FL 33146
Phone (305) 585-1052

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1475 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4200

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1710083506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071410",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21355 E DIXIE HWY STE 111",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "33180",
            "telephone_number": "305-692-1100",
            "fax_number": "305-692-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3426 N Roosevelt Blvd",
            "address_purpose": "LOCATION",
            "city": "Key West",
            "state": "FL",
            "postal_code": "330404224",
            "country_code": "US",
            "telephone_number": "305-296-0021",
            "fax_number": "305-296-0061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5555 Ponce De Leon Blvd",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331462513",
            "country_code": "US",
            "telephone_number": "305-689-5555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5555 Ponce De Leon Blvd",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331462513",
            "country_code": "US",
            "telephone_number": "305-689-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHAMAD",
        "first_name": "ANESA",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "L8584",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME89438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA THRU KEYS PHA",
            "identifier": "7490640",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1052055",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "14C0H",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158343701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "346218",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "789645",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00921457",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003252000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.