Active NPI
Vincent A Degennaro, M.D.
- Surgery Physician
- Miami, FL
National Provider Identifier
1952390817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- ME50676
- Practice address
- 1201 NW 16TH St
Miami, FL 33125-1624 - Phone
- (305) 575-3244
- Fax
- (305) 575-3255
- NPI assigned
- Oct 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ME50676 | FL | Primary |
| Colon & Rectal Surgery Physician | 208C00000X | ME50676 | FL |
Addresses
Primary practice location
1201 NW 16TH St
Miami, FL 33125-1624
Mailing address
1201 NW 16TH St
Miami, FL 33125-1624
Phone (305) 575-3244
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03892 | Other | FL | BLUE CROSS BLUE SHIELD |
| 225451 | Other | FL | AVMED |
| D19041 | Other | FL | VISTA |
| 002517 | Other | FL | NEIGHBORHOOD HEALTH |
| 020012679 | Other | RAILROAD RETIREMENT | |
| 4075362 | Other | AETNA |
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 |
|---|---|---|---|
| ME50676 | FL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248912000000",
"number": "1952390817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 NW 16TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331251624",
"telephone_number": "305-575-3244",
"fax_number": "305-575-3255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 NW 16TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331251624",
"telephone_number": "305-575-3244",
"fax_number": "305-575-3255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGENNARO",
"first_name": "VINCENT",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-13",
"last_updated": "2009-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME50676",
"primary": true
},
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "FL",
"license": "ME50676",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "03892",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "225451",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISTA",
"identifier": "D19041",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH",
"identifier": "002517",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD RETIREMENT",
"identifier": "020012679",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4075362",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.