Individual provider Active NPI

Vincent Degennaro Jr., MD, MPH

  • Internal Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1821258419
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME115181 Issued in FL
Practice address
6333 N Federal Hwy Ste 301302
Fort Lauderdale, FL 33308-1907
Phone
(954) 772-2411
NPI assigned
Jun 17, 2008
Last updated
Jun 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 255868 NY
Internal Medicine Physician 207R00000X ME115181 FL Primary

Addresses

Primary practice location

6333 N Federal Hwy Ste 301302
Fort Lauderdale, FL 33308-1907

Mailing address

6255 W Sunset Blvd FL 21
Los Angeles, CA 90028-7422
Phone (323) 860-5200

Other identifiers 1

IdentifierTypeStateIssuer
008801400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX, NH3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20130719000215 FL Practitioner - Internal Medicine 7416198387 Reassigns benefits to 3 organizations
I20190124002798 TX Practitioner - Internal Medicine 7416198387 Reassigns benefits to 1 organization
I20190225002915 NH Practitioner - Internal Medicine 7416198387

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Miami, LM Miller School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
AIDS Healthcare FoundationGroup PAC ID 2668369109, 101 clinicians

Practice addresses (Care Compare)

12725 Griffing Blvd
North Miami, FL 33161-4636
Phone (305) 984-6249

6333 N Federal Hwy
Suite 301 302
Fort Lauderdale, FL 33308-1412
Phone (954) 772-2411

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME115181FLMDInternal Medicine Physician
255868NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Pintado Clinic CurrentSince Dec 14, 2018 Accepting new patients
DHHS PHS Naihs Crownpoint Hospital Current Accepting new patients
Eastside Hospitalists Inc CurrentSince Feb 1, 2025 Accepting new patients
AIDS Healthcare Foundation Current Accepting new patients
AIDS Healthcare Foundation Internal Medicine CurrentSince May 19, 2025 Accepting new patients
Thoreau Clinic CurrentSince Dec 14, 2018 Accepting new patients
Citrus Homecare LLC Internal Medicine CurrentSince Jan 24, 2025 Accepting new patients
AIDS Healthcare Foundation CurrentSince May 19, 2025 Accepting new patients

Locations

6255 W Sunset Blvd
Fl 21
Los Angeles, CA 90028
Phone (323) 860-5200

6333 N Federal Hwy
Ste 301302
Ft Lauderdale, FL 33308
Phone (954) 772-2411

3600 Washington St
Hollywood, FL 33021
Phone (954) 265-4461

100 NW 170th St
Ste 208
North Miami Beach, FL 33169
Phone (305) 405-0045

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

3135 State Road 580
Ste 1
Safety Harbor, FL 34695
Phone (727) 259-2000

Interoperability endpoints

  • Direct secure messaging: vincent.degennaro.1@24158.direct.athenahealth.com
  • Direct secure messaging: vincent.degennaro.1@26356.direct.athenahealth.com

Organizations & group practices 8

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.

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1821258419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 W SUNSET BLVD FL 21",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287422",
            "telephone_number": "323-860-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 N FEDERAL HWY STE 301302",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081907",
            "telephone_number": "954-772-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGENNARO",
        "first_name": "VINCENT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "255868",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME115181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008801400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.