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JOSEPH P. GJOLAJ M.D.
NPI 1578609137
Orthopaedic Surgery in Miami, FL

Active since January 30, 2007PECOS EnrolledAccepts Medicare Assignment
81.31/100
CMS Quality Rating
1475 NW 12TH AVE, MIAMI, FL 33136(305) 243-3000(305) 243-7658 Get Directions Write a Review

NPPES record last updated: April 25, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Joseph P. Gjolaj M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOSEPH P. GJOLAJ M.D. (NPI 1578609137) is an individual orthopaedic surgery provider in Miami, Florida, licensed in Florida (ME116568) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Jackson Health System, and is a graduate of George Washington University School Of Medicine (2006).

NPPES Registry Identity

NPI1578609137
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameJOSEPH P. GJOLAJCredential: M.D.
Location Address1475 NW 12TH AVEMiami, FL 33136-1002
Mailing Address1475 Nw 12th AveMiami, FL 33136-1002 · (305) 243-3000 · Fax (305) 243-7658
Phone(305) 243-3000
Fax(305) 243-7658
Sole ProprietorNo
Medical School CMSGeorge Washington University School Of MedicineGraduated 2006
Enumeration DateJanuary 30, 2007
Last NPPES UpdateApril 25, 2014
✔ NPI 1578609137 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in FL · ME116568
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
1475 NW 12TH AVE, Miami, FL 33136
Open in Google Maps ↗

Other Identifiers 2

Medicare OSCAR/certificationHN558ZFL
Medicaid0095758-00FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Joseph P. Gjolaj M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800048505
PECOS Enrollment IDI20130912000643
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Fusion of additional segment of spine 22614
Fusion of an additional segment of the spine is a surgical procedure to join two or more vertebrae together. This is done to stabilize the spine and reduce pain or correct a deformity. The procedure involves using bone grafts, rods, or screws to secure the spine.
167 services26 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
160 services115 patients
Incision or removal of spine bone segment, each additional segment 22216
This procedure involves making an incision to remove a portion of the spine bone, often to alleviate pressure or pain. If more segments need to be removed, the process is repeated for each additional segment. This is done under general anesthesia.
86 services20 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
69 services69 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
24 services21 patients
Incision or removal of lower spine bone segment 22214
This procedure involves making a small incision in the lower back to access the spine. A segment of bone may be removed to relieve pressure on nerves, improve mobility, or treat conditions like herniated discs or spinal stenosis. Recovery varies, but physical therapy may follow.
17 services17 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jackson Health System

Acute Care Hospitals · Miami, FL
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100022
Location1611 NW 12th AveMiami, FL 33136 · Miami-Dade County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33136 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.13 typical visit price
range $60.92 – $187.05
Typical copayment $24.03 (range $15.23 – $46.76)
Most-billed visit code 99203
Established Patient
$75.86 typical visit price
range $18.99 – $150.24
Typical copayment $18.96 (range $4.74 – $37.56)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.45
Promoting Interoperability100
Improvement Activities40
Cost50.59

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Osteogenesis stimulator, electrical, non-invasive, spinal applications E0748
DME-Other DME · category DE000N
1 supplier23 claims23 services$3,753.38 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. ALISSETTE NAVEDA ARNP
Nurse Practitioner (Family)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-5360
WALTER G BRADLEY
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1475 NW 12TH AVE, BOX 016960 M851
MIAMI, FL 33136
Miami-Dade County (305) 243-7520
DR. EVAN H SCHLAM MD
Dermatology
1475 NW 12TH AVE, BOX 016960
MIAMI, FL 33136
Miami-Dade County (305) 243-7688
DR. NESTOR RICARDO VILLAMIZAR M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-2363
MS. LINDSAY MARIE THORNTON MD
Radiology (Vascular & Interventional Radiology)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-5512
DR. GLENDA C HARRIS PH.D., L.AC.
Acupuncturist
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-1470
IVAYLO MIHAYLOV
Radiology (Radiation Oncology)
1475 NW 12TH AVE, SUITE 1500
MIAMI, FL 33136
Miami-Dade County (305) 243-8223
LOURDES MESTRE VALDES APRN
Nurse Practitioner (Gerontology)
1475 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-4902

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Joseph Gjolaj's NPI number?

The NPI number for Joseph Gjolaj is 1578609137. It was assigned to this individual provider in the NPPES registry on January 30, 2007.

Where is Joseph Gjolaj located?

Joseph Gjolaj practices at 1475 NW 12th Ave, Miami, FL 33136. The listed phone number is (305) 243-3000.

What is Joseph Gjolaj's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Joseph Gjolaj enrolled in Medicare?

Yes. Joseph Gjolaj is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Joseph Gjolaj accept?

Health plans from AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare and Oscar Health Maintenance Organization of Florida and 1 other insurer list Joseph Gjolaj as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Joseph Gjolaj affiliated with any hospitals?

According to CMS data, Joseph Gjolaj is affiliated with Jackson Health System.

When was this NPI record last updated?

The NPPES record for Joseph Gjolaj was last updated on April 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.