1. Home
  2. Directory
  3. Florida
  4. Miami
  5. Family Medicine
  6. NPI Profile

WATERWAY MED GROUP LLC
NPI 1952027104
Family Medicine in Miami, FL

Active since October 18, 2022CLIA 10D2283422 · Waiver
7001 N WATERWAY DR STE 107, MIAMI, FL 33155(786) 542-9832(786) 685-2585 Get Directions Write a Review

NPPES record last updated: August 9, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 9, 2023, Oct 18, 2022 (2 updates tracked since 2022).

About Waterway Med Group Llc NPPES

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

WATERWAY MED GROUP LLC (NPI 1952027104) is a healthcare organization registered as a family medicine in Miami, Florida and active in the NPI registry since October 2022. The organization holds a CLIA Waiver certificate valid through June 6, 2027 and lists Jesus Urgelles, President, as its authorized official.

NPPES Registry Identity

NPI1952027104
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameWATERWAY MED GROUP LLC
Location Address7001 N WATERWAY DR STE 107Miami, FL 33155-2827
Mailing Address7001 N Waterway Dr Ste 107Miami, FL 33155-2827 · (786) 542-9832 · Fax (786) 685-2585
Phone(786) 542-9832
Fax(786) 685-2585
Organization SubpartNo
Authorized OfficialJesus UrgellesPresident · (786) 542-9832
Enumeration DateOctober 18, 2022
Last NPPES UpdateAugust 9, 20232 updates tracked since enumeration
NPPES CertifiedAugust 9, 2023
✔ NPI 1952027104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
7001 N WATERWAY DR STE 107, Miami, FL 33155
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Waterway Med Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Waterway Med Group LLC, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Guillermo Fonseca, M.D.
General Practice
NPI 1972700714
11880 SW 40TH ST SUITE 318
Miami, FL 33175
(305) 223-3989
✔ PECOS✔ Accepts Medicare5.0 mi
Thomas Lange, MPT
Physical Therapist in Private Practice
NPI 1952731762
9570 SW 107TH AVE SUITE 201C
Miami, FL 33176
(954) 980-8364
✔ Accepts Medicare5.6 mi
Pedro Machin, OTR
Occupational Therapist in Private Practice
NPI 1972644151
5721 SW 165TH CT
Miami, FL 33193
(305) 383-8530
✔ Accepts Medicare9.8 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2283422

Waterway Med Group LLC · Miami, FL
Active · expires Jun 6, 2027
CLIA Number10D2283422
Laboratory TypePhysician Office
Certificate Effective DateJune 7, 2025
Certificate Expiration DateJune 6, 2027
Laboratory DirectorJody Scott Greenfield
Laboratory Phone(786) 542-9832
Laboratory LocationWaterway Med Group LLC7001 N Waterway Dr Suite 107, Miami, FL 33155
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Waterway Med Group LLC's NPI number?

The NPI number for Waterway Med Group LLC is 1952027104. It was assigned to this organization in the NPPES registry on October 18, 2022.

Where is Waterway Med Group LLC located?

Waterway Med Group LLC is located at 7001 N Waterway Dr Ste 107, Miami, FL 33155. The listed phone number is (786) 542-9832.

What is Waterway Med Group LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Waterway Med Group LLC enrolled in Medicare?

Yes. Waterway Med Group LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Waterway Med Group LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Waterway Med Group LLC, in General Practice, Occupational Therapist in Private Practice and Physical Therapist in Private Practice. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Waterway Med Group LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2283422) is associated with this NPI, valid through June 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Waterway Med Group LLC was last updated on August 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.