Individual provider Active NPI

Luis E Raez, MD

  • Hematology & Oncology Physician
  • Pembroke Pines, FL
National Provider Identifier
1922030071
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME71292 Issued in FL
Practice address
801 N Flamingo Rd
Suite 11
Pembroke Pines, FL 33028-1046
Phone
(954) 844-6868
Fax
(954) 443-4747
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X ME71292 FL Primary

Addresses

Primary practice location

801 N Flamingo Rd
Suite 11
Pembroke Pines, FL 33028-1046

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025
Phone (954) 276-5685

Other identifiers 1

IdentifierTypeStateIssuer
2540321-00MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lraez56260@MHSDIRECT.NET Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110318000644 FL Practitioner - Medical OncologyPractitioner - Hematology/Oncology 6901089507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

1150 N 35TH Ave
Suite 170
Hollywood, FL 33021-5424
Phone (954) 265-4325

Hospital & facility affiliations

  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038
  • Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285
  • Memorial Hospital Pembroke Hospital, Pembroke Pines, FL, CCN 100230
  • Cleveland Clinic Hospital Hospital, Weston, FL, CCN 100289

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME71292FLMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District CurrentSince Jun 1, 2011 Accepting new patients
South Broward Hospital District Hematology & Oncology CurrentSince Jun 1, 2011 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

20801 Biscayne Blvd
Ste 200
Aventura, FL 33180
Phone (954) 265-3015

20950 NE 27th Ct
Ste 203
Aventura, FL 33180
Phone (305) 933-6545

1150 N 35th Ave
Ste 170
Hollywood, FL 33021
Phone (954) 985-1500

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

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

12235 Pines Blvd
Pembroke Pines, FL 33026
Phone (954) 265-1125

801 N Flamingo Rd
Ste 11
Pembroke Pines, FL 33028

Interoperability endpoints

  • Direct secure messaging: lraez56260@mhsdirect.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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1922030071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "33025",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N FLAMINGO RD",
            "address_2": "SUITE 11",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281046",
            "telephone_number": "954-844-6868",
            "fax_number": "954-443-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAEZ",
        "first_name": "LUIS",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME71292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2540321-00",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lraez56260@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "801 N Flamingo Rd",
            "address_2": "SUITE 11",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330281046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.