NPIMap

Organization Active NPI

Genesiscare USA of Florida LLC

Doing business as Broward Urology

  • Urology Physician
  • Miramar, FL
National Provider Identifier
1841580917
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
GENESISCARE USA OF FLORIDA LLC
Doing business as
Broward Urology
Practice address
1951 SW 172ND Ave Ste 300
Miramar, FL 33029-5614
Phone
(954) 499-7696
Fax
(954) 499-7699
NPI assigned
Apr 11, 2011
Last updated
Nov 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GENESISCARE USA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Authorized official

Name
Ian Wong
Title
Cfo
Phone
(303) 249-7486

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

1951 SW 172ND Ave Ste 300
Miramar, FL 33029-5614

Mailing address

1419 SE 8TH Ter Ste 200
Cape Coral, FL 33990-3213
Phone (239) 931-7342

Other identifiers 1

IdentifierTypeStateIssuer
CE7138OtherFLRAILROAD MEDICARE

Other names 1

  • Broward Urology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204000663 FL Part B Supplier - Clinic/Group Practice 9830082882 Receives reassigned benefits from 314 practitioners
This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1048859Genesiscare USA of Florida, LLC1951 SW 172ND Ave Ste 300, Miramar, FL 33029Certificate of waiverDec 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
James W Orr Jr MD72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1951 SW 172nd Ave
Ste 300
Miramar, FL 33029
Phone (954) 499-7696

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1841580917",
    "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": "1951 SW 172ND AVE STE 300",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295614",
            "telephone_number": "954-499-7696",
            "fax_number": "954-499-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESISCARE USA OF FLORIDA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESISCARE USA INC",
        "enumeration_date": "2011-04-11",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-249-7486"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CE7138",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broward Urology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Broward Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.