NPIMap

Individual provider Active NPI

Vladislav Gorbatiy, M.D.

  • Urology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1831414143
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME110963 Issued in FL
Practice address
1200 E Broward Blvd
Fort Lauderdale, FL 33301-2134
Phone
(954) 463-6408
Fax
(954) 463-1858
NPI assigned
Mar 30, 2010
Last updated
Mar 31, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN#14540 FL
Urology Physician 208800000X ME110963 FL Primary

Addresses

Primary practice location

1200 E Broward Blvd
Fort Lauderdale, FL 33301-2134

Mailing address

2234 Colonial Blvd
Attn: Payer Contracting & Relations
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other identifiers 14

IdentifierTypeStateIssuer
P1002957OtherFLFREEDOM HEALTH
P943414OtherFLOPTIMUM
25877OtherFLMEDICA
P0005386OtherFLFLORIDA HEALTHCARE PLUS
006449600MedicaidFL
13088OtherFLDIMENSIONS HEALTH
9916895OtherFLAETNA
F00349514201OtherFLUNITED HEALTHCARE
3674924OtherFLCIGNA
P01099396OtherFLRAILROAD MEDICARE
QMP000004921476OtherFLMOLINA
813583OtherFLWELLCARE
P01727492OtherFLSIMPLY HEALTHCARE
14LY8OtherFLBCBS FL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121015000707 FL Practitioner - Urology 7012167752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Emory University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Genesiscare USA of Florida LLCGroup PAC ID 9830082882, 172 clinicians

Practice addresses (Care Compare)

1419 SE 8TH Ter
Cape Coral, FL 33990-3213
Phone (239) 772-3202

2021 E Commercial Blvd
Suite 302
Fort Lauderdale, FL 33308-3754
Phone (954) 491-0030

2150 S Andrews Ave
Suite 100
Fort Lauderdale, FL 33316-3432
Phone (954) 463-6408

730 Goodlette Rd
Suite 201
Naples, FL 34102-5618
Phone (239) 263-4499

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as individual
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME110963FLMDUrology Physician
TRN#14540FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Genesiscare USA of Florida LLC Urology Current Accepting new patients
Genesiscare USA of Florida LLC Urology CurrentSince Aug 13, 2012 Accepting new patients
21St Century Oncology LLC CurrentSince Aug 13, 2012 Accepting new patients
Genesiscare USA of Florida LLC Urology Current Accepting new patients

Locations

1419 SE 8th Ter
Cape Coral, FL 33990
Phone (239) 772-3202

2160 Colonial Blvd
Fort Myers, FL 33907

2234 Colonial Blvd
Fort Myers, FL 33907
Phone (239) 931-7212

1200 E Broward Blvd
Ft Lauderdale, FL 33301
Phone (954) 463-6408

2021 E Commercial Blvd
Ste 302
Ft Lauderdale, FL 33308
Phone (954) 491-0030

2150 S Andrews Ave
Ste 100
Ft Lauderdale, FL 33316
Phone (954) 463-6408

730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: vladislavgorbatiy@fyc.medalliesdirect.net

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.

Hospital & facility affiliations 10

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": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1831414143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "address_2": "ATTN: PAYER CONTRACTING & RELATIONS",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "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": "1200 E BROWARD BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012134",
            "telephone_number": "954-463-6408",
            "fax_number": "954-463-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORBATIY",
        "first_name": "VLADISLAV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-30",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN#14540",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME110963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM HEALTH",
            "identifier": "P1002957",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "P943414",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "25877",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA HEALTHCARE PLUS",
            "identifier": "P0005386",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006449600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIMENSIONS HEALTH",
            "identifier": "13088",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9916895",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "F00349514201",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3674924",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01099396",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "QMP000004921476",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "813583",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIMPLY HEALTHCARE",
            "identifier": "P01727492",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS  FL",
            "identifier": "14LY8",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.