Active NPI
Genesiscare USA of Florida LLC
Doing business as Lauderdale Urology Associates
- Urology Physician
- Oakland Park, FL
National Provider Identifier
1821305467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- GENESISCARE USA OF FLORIDA LLC
- Doing business as
- Lauderdale Urology Associates
- Practice address
- 5301 N Dixie Hwy
Suite 201
Oakland Park, FL 33334-3447 - Phone
- (954) 772-1220
- NPI assigned
- Sep 2, 2010
- Organization subpart
- Yes
- Parent organization
- GENESISCARE USA INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shaden Marzouk
- Title
- President
- Phone
- (239) 931-7254
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
5301 N Dixie Hwy
Suite 201
Oakland Park, FL 33334-3447
Mailing address
1419 SE 8TH Ter Ste 200
Cape Coral, FL 33990-3213
Phone (239) 931-7342
Other names 1
- Lauderdale Urology Associates
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryNetworks
- 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.
-
- Urology Physician
- Oakland Park, FL
- NPI 1669568069
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283385600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1696464000000",
"number": "1821305467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1419 SE 8TH TER STE 200",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339903213",
"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": "5301 N DIXIE HWY",
"address_2": "SUITE 201",
"city": "OAKLAND PARK",
"state": "FL",
"postal_code": "333343447",
"telephone_number": "954-772-1220"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GENESISCARE USA OF FLORIDA LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GENESISCARE USA INC.",
"enumeration_date": "2010-09-02",
"last_updated": "2023-10-05",
"certification_date": "2023-10-05",
"status": "A",
"authorized_official_last_name": "MARZOUK",
"authorized_official_first_name": "SHADEN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "239-931-7254"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Lauderdale Urology Associates",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Lauderdale Urology Associates",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Oakland Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.