Active NPI
Peter Roger Genovese, M.D.
- Adult Medicine Physician
- Ft Lauderdale, FL
National Provider Identifier
1831579762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- 13626
- Practice address
- 936 Intracoastal Dr
PH 4
Ft Lauderdale, FL 33304-3640 - Phone
- (954) 565-2070
- NPI assigned
- Jun 5, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | 13626 | FL | Primary |
Addresses
Primary practice location
936 Intracoastal Dr
PH 4
Ft Lauderdale, FL 33304-3640
Mailing address
936 Intracoastal Dr
PH 4
Ft Lauderdale, FL 33304-3640
Phone (954) 565-2070
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13626 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433462400000",
"number": "1831579762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "936 INTRACOASTAL DR",
"address_2": "PH 4",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333043640",
"telephone_number": "954-565-2070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "936 INTRACOASTAL DR",
"address_2": "PH 4",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333043640",
"telephone_number": "954-565-2070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENOVESE",
"first_name": "PETER",
"middle_name": "ROGER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-05",
"last_updated": "2015-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "FL",
"license": "13626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.