Plan Provider Directory This directory provides a list of PHP’s (HMO SNP) network providers. This directory is for Broward and Miami-Dade Counties, Florida. This directory is current as of October 19, 2016. Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. To get the most up-to- date information about PHP’s network providers in your area, you can visit www.php.org/for-members/using-plan or call our Member Services Department at (888) 456-4715, 8:00 a.m. to 8:00 p.m., seven days a week. TTY users should call 711. PHP is an HMO plan with a Medicare contract. Enrollment in PHP depends on contract renewal. This information is available for free in other languages. Please contact our Member Services number at (888) 456-4715, seven days a week, 8:00 a.m. to 8:00 p.m., for additional information. TTY users should call711. Esta información está disponible de forma gratuita en otros idiomas. Por favor, póngase en contacto con el Departamento de servicios para miembros al (888) 456-4715, siete días a la semana, de 8:00 a.m. a 8:00 p.m, para obtener información adicional. Los usuarios de TTY deben llamar al 711. This document may be available in an alternate format such as Braille, larger print or audio. Please contact our Member Services number at (888) 456-4715, seven days a week, 8:00 a.m. to 8:00 p.m., for additional information. TTY users should call711. H3132_1080 2017 Broward-Dade 101916 Discrimination Is Against the Law PHP (HMO SNP) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. PHP does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. PHP: • Provides free aids and services to people with disabilities to communicate effectively with us, such as: Qualified sign language interpreters o Written information in other formats (large print, audio, accessible o electronic formats, other formats) • Provides free language services to people whose primary language is not English, such as: Qualified interpreters o Information written in other languages o If you need these services, contact Member Services. If you believe that PHP has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Member Services, P.O. Box 46160, Los Angeles, CA 90046, (888) 456- 4715, TTY 711, Fax (888) 235-8552, email [email protected]. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Member Services is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, DC 20201 1-800-368-1019, 1-800-537-7697 (TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-456-4715 (TTY: 711). ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-888-456-4715 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-888-456-4715 (TTY: 711). ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-888-456-4715 (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-888-456-4715 （TTY：711） ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-888-456-4715 (ATS : 711). PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-888-456-4715 (TTY: 711). ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-888-456-4715 (телетайп: 711). 1-888-456-4715 مﻗﺮﺒ لﺼﺘا .نﺎﺠﻤﻟﺎﺒ كﻟ ﺮﻓاوﺘﺘ ﺔﻴوﻐﻠﻟا ةدﻋﺎﺴﻤﻟا تﺎﻤدﺨ نﺈﻓ ،ﺔﻐﻠﻟا ﺮﻛذا ثدﺤﺘﺘ تﻨﻛ اذإ :ﺔظوﺤﻠﻤ .(711 :مﻛﺒﻟاو مﺼﻟا فﺘﺎھ مﻗر) ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-888-456-4715 (TTY: 711). ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-888-456-4715 (TTY: 711). 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1- 888-456-4715 (TTY: 711) 번으로 전화해 주십시오. UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-888-456-4715 (TTY: 711). - ii - : , : . �ચુ ના જો તમે �જુ રાતી બોલતા હો તો િન �લ્ુ ક ભાષા સહાય સેવાઓ તમારા માટ� ઉપલબ્ધ છે ફોન 1-888-456-4715 (TTY: 711). કરો เรียน: ถ้าคณุ พดู ภาษาไทยคณุ สามารถใช้บริการช่วยเหลือทางภาษาได้ฟรี โทร 1-888-456-4715 (TTY: 711). - iii - Table of Contents Section 1 – Introduction ................................................................................................... 1 What is the service area for PHP? ....................................................................................................... 2 How do you find PHP providers in your area? .............................................................................. 2 Primary Care Provider (PCP) Network ............................................................................ 3 Specialist Network ........................................................................................................... 10 Allergy & Immunology ......................................................................................................................... 10 Cardiology ................................................................................................................................................. 13 Certified Nurse Midwife ....................................................................................................................... 23 Chiropractor .............................................................................................................................................. 24 Dermatology ............................................................................................................................................. 26 Endocrinology .......................................................................................................................................... 29 Gastroenterology .................................................................................................................................... 31 Genetics Medicine .................................................................................................................................. 35 Geriatric Medicine .................................................................................................................................. 36 Gynecologic Oncology ......................................................................................................................... 38 Hematology Oncology ......................................................................................................................... 38 Hepatology ............................................................................................................................................... 43 Infectious Disease ................................................................................................................................... 44 Nephrology ............................................................................................................................................... 47 Neurology .................................................................................................................................................. 51 Neurosurgery ........................................................................................................................................... 57 Nuclear Medicine ................................................................................................................................... 59 Obstetrics & Gynecology .................................................................................................................... 60 Ophthalmology ....................................................................................................................................... 68 Ophthalmology, Retina And Vitreous Diseases ......................................................................... 79 Otolaryngology (ENT) ........................................................................................................................... 80 Pain Medicine ........................................................................................................................................... 85 Physical Medicine & Rehabilitation ................................................................................................ 87 Podiatry ...................................................................................................................................................... 88 Pulmonology ............................................................................................................................................ 92 Radiation Oncology ............................................................................................................................... 96 Respiratory Therapy ........................................................................................................................... 101 Rheumatology ...................................................................................................................................... 101 Sports Medicine ................................................................................................................................... 103 Surgery, Cardiothoracic ..................................................................................................................... 103 Surgery, Cardiovascular .................................................................................................................... 104 Surgery, Colon & Rectal .................................................................................................................... 105 - i - Surgery, General ................................................................................................................................... 106 Surgery, Hand ....................................................................................................................................... 111 Surgery, Oncology .............................................................................................................................. 112 Surgery, Oral & Maxillofacial .......................................................................................................... 113 Surgery, Orthopedic ........................................................................................................................... 114 Surgery, Plastic ..................................................................................................................................... 119 Surgery, Thoracic ................................................................................................................................. 120 Surgery, Transplant ............................................................................................................................. 121 Surgery, Vascular ................................................................................................................................. 121 Urology .................................................................................................................................................... 122 Hospital Network ........................................................................................................... 127 Eye Hospital ........................................................................................................................................... 127 General Acute Care ............................................................................................................................. 127 Psychiatric Hospital ............................................................................................................................. 127 Skilled Nursing Facility Network ................................................................................. 129 Behavioral Health Provider Network .......................................................................... 131 Marriage & Family Therapist .......................................................................................................... 131 Mental Health Clinic ........................................................................................................................... 131 Psychiatry ................................................................................................................................................ 133 Psychology ............................................................................................................................................. 135 Social Worker ........................................................................................................................................ 138 Dental Care Network ..................................................................................................... 141 Vision Care Network ...................................................................................................... 144 Ancillary Services Network .......................................................................................... 164 Audiology ............................................................................................................................................... 164 Clinical Laboratory .............................................................................................................................. 166 Diagnostic Imaging Center .............................................................................................................. 167 Dialysis ..................................................................................................................................................... 168 Durable Medical Equipment & Supplies .................................................................................... 170 Home Health ......................................................................................................................................... 172 Hospital, Rehabilitation ..................................................................................................................... 174 Nutritionist ............................................................................................................................................. 174 Occupational Therapy ........................................................................................................................ 175 Outpatient Surgery Center .............................................................................................................. 175 Physical Therapy .................................................................................................................................. 176 Prosthetics & Orthotics ..................................................................................................................... 178 Speech Therapy .................................................................................................................................... 178 Urgent Care ............................................................................................................................................ 180 Part B Pharmacy Network ............................................................................................ 181 Notes ............................................................................................................................... 223 - ii - Section 1 – Introduction This directory provides a list of PHP’s network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage. You will have to choose one of our network providers who are listed in this directory to be your Primary Care Provider (PCP). The term “PCP” will be used throughout this directory. Generally, you must get your health care coverage from your PCP. The “network providers” listed in this directory have agreed to provide you with your health care, vision, dental and behavioral health coverage. You may go to any of our network providers listed in this directory; however, some services may require a referral. If you have been going to one network provider, you are not required to continue to go to that same provider. In some cases, you may get covered services from non-network providers. Other providers are available in our network. If you get a bill from a network or out of network provider for health care services you received, submit it to PHP so we can determine if the plan or you are liable for payment. If we determine the plan is liable, PHP will pay the bill. Submit bills to: Attn: Member Services PHP P.O. Box 46160 Los Angeles, CA 90046 You can also fax your bill to (888) 235-8552. If you have questions about a bill, call Member Services at (888) 456-4715, seven days a week, 8:00 a.m. to 8:00 p.m. TTY users call 711. If you are out of the plan’s service area (Broward and Miami-Dade Counties, Florida) and have a medical emergency, call 911 or go to the closest hospital. Contact Member Services at (888) 456-4715 (TTY 711), seven days a week, 8:00 a.m. to 8:00 p.m., as soon as possible to advise us that you had a medical emergency. You must use plan providers except in emergency or urgent care situations or for out- of-area renal dialysis or other services. If you obtain routine care from out-of-network providers neither Medicare nor PHP will be responsible for the costs. - 1 - What is the service area for PHP? The counties in our service area are listed below. • Duval County, Florida • Broward County, Florida • Miami-Dade County, Florida How do you find PHP providers in your area? To find a provider, like a PCP, specialist or hospital, look in the table of contents to find the section of the directory that lists the type of provider you need. In the case of specialists, find the specialty you need. Go to that section of the directory and find the county and city that is closest to you and choose a provider. If you have questions about PHP or require assistance in selection a PCP, please call our Member Services Department at (888) 456-4715, 8:00 a.m. to 8:00 p.m., seven days a week. TTY users should call 711. Or, visit www.php-fl.org/for-members/using-plan. - 2 - Section 2 – List of Network Providers PHP Primary Care Provider (PCP) Network PRIMARY CARE PROVIDER HAYDEN, ANNA, DO SHARMA, SHEETAL, MD 1111 W BROWARD BLVD 1101 SW 1ST ST BROWARD COUNTY FORT LAUDERDALE, FL 33312 FORT LAUDERDALE, FL 33312 DANIA BEACH TEL: (954) 463-7313 TEL: (954) 467-0880 SCIBERRAS, ANDREA, DO 101 S FEDERAL HWY HEGLAR, ROBERT, MD HOLLYWOOD DANIA BEACH, FL 33004 1164 E OAKLAND PARK BLVD PANDO, EMILIO, MD TEL: (954) 399-9941 3RD FLR 12781 MIRAMAR PKWY FORT LAUDERDALE, FL 33334 HOLLYWOOD, FL 33027 FORT LAUDERDALE TEL: (954) 561-6900 TEL: (954) 450-0228 ARAMBURU, MARLENE, MD 6405 N FEDERAL HIGHWAY LEE, MARAH, DO OAKLAND PARK SUITE 300 5333 N DIXIE HWY STE 110 CUENCA, MICHAEL, MD FORT LAUDERDALE, FL 33308 FORT LAUDERDALE, FL 33334 1164 E OAKLAND PARK BLVD TEL: (954) 771-7294 TEL: (954) 772-8554 OAKLAND PARK, FL 33334 TEL: (954) 561-6900 CENNAMO, JAMES, DO MCLEAN, ARCHIE, DO 6405 N FEDERAL HWY STE 205 1111 W BROWARD BLVD POMPANO BEACH FORT LAUDERDALE, FL 33308 FORT LAUDERDALE, FL 33312 MCLEAN, ARCHIE, DO TEL: (954) 772-2411 TEL: (954) 463-7313 2011 NW 3RD AVE POMPANO BEACH, FL 33060 CUENCA, MICHAEL, MD RICHMOND, GARY, MD TEL: (954) 463-7313 4725 N FEDERAL HWY 315 SE 14TH STREET FORT LAUDERDALE, FL 33308 FORT LAUDERDALE, FL 33316 PRIMARY CARE PROVIDER TEL: (954) 771-8000 TEL: (954) 524-2250 MIAMI-DADE COUNTY DWYER, JAMES, DO SCHUMANN, ESTHER, MD CUTLER BAY 6405 N FEDERAL HWY STE 205 305 S ANDREWS AVE STE 601 AMOFAH, SAINT ANTHONY, FORT LAUDERDALE, FL 33308 FORT LAUDERDALE, FL 33301 MD TEL: (954) 772-2411 TEL: (954) 767-0887 10300 SW 216TH ST CUTLER BAY, FL 33190 ELLIOTT, RAYMOND, MD SEJOUR, JOSETTE, DO TEL: (305) 252-4841 1111 W BROWARD BLVD 1101 NW 1ST ST FORT LAUDERDALE, FL 33312 FORT LAUDERDALE, FL 33311 BLANCO, ARMANDO, MD TEL: (954) 463-7313 TEL: (954) 786-5901 10300 SW 216TH ST CUTLER BAY, FL 33190 GORENSEK, MARGARET, MD SEJOUR, JOSETTE, DO TEL: (305) 252-4841 5601 N DIXIE HWY STE 107 1726 SE 3RD AVE FORT LAUDERDALE, FL 33334 FORT LAUDERDALE, FL 33316 BOSA-OSORIO, EDWIN, MD TEL: (954) 493-9752 TEL: (954) 522-4749 10300 SW 216TH ST CUTLER BAY, FL 33190 GUERRA, CARLOS, MD SENSION, MICHAEL, MD TEL: (305) 252-4841 5601 N DIXIE HWY STE 107 1101 NW 1ST ST FORT LAUDERDALE, FL 33334 FORT LAUDERDALE, FL 33311 CELOGE, MARIE, MD TEL: (954) 493-9752 TEL: (954) 467-0880 10300 SW 216TH ST CUTLER BAY, FL 33190 TEL: (305) 252-4841 - 3 - PHP Primary Care Provider (PCP) Network GONZALEZ, FRANCISCO, MD CELOGE, MARIE, MD OPER, ARNOLD, MD 10300 SW 216TH ST 810 W MOWRY DR 810 W MOWRY DR CUTLER BAY, FL 33190 HOMESTEAD, FL 33030 HOMESTEAD, FL 33030 TEL: (305) 252-4841 TEL: (305) 248-4334 TEL: (305) 248-4334 NUNEZ, EDGARD, MD CELOGE, MARIE, MD OPER, ARNOLD, MD 10300 SW 216TH ST 13600 SW 312TH ST 13805 SW 246TH ST CUTLER BAY, FL 33190 HOMESTEAD, FL 33033 HOMESTEAD, FL 33031 TEL: (305) 252-4841 TEL: (305) 242-6069 TEL: (305) 258-6813 OPER, ARNOLD, MD CELOGE, MARIE, MD OPER, ARNOLD, MD 10300 SW 216TH ST 19300 SW 376TH ST 13600 SW 312TH ST CUTLER BAY, FL 33190 HOMESTEAD, FL 33034 HOMESTEAD, FL 33033 TEL: (305) 252-4841 TEL: (305) 246-4607 TEL: (305) 242-6069 PHILIPPE, ELIZABETH, MD GONZALEZ, FRANCISCO, MD OPER, ARNOLD, MD 10300 SW 216TH ST 810 W MOWRY DR 19300 SW 376TH ST CUTLER BAY, FL 33190 HOMESTEAD, FL 33030 HOMESTEAD, FL 33034 TEL: (305) 252-4841 TEL: (305) 248-4334 TEL: (305) 246-4607 ROSS, CHARLES, MD GONZALEZ, FRANCISCO, MD PHILIPPE, ELIZABETH, MD 10300 SW 216TH ST 13600 SW 312TH ST 810 W MOWRY DR CUTLER BAY, FL 33190 HOMESTEAD, FL 33033 HOMESTEAD, FL 33030 TEL: (305) 252-4841 TEL: (305) 242-6069 TEL: (305) 248-4334 WRIGHT, TAMARA, MD GONZALEZ, FRANCISCO, MD PHILIPPE, ELIZABETH, MD 10300 SW 216TH ST 19300 SW 376TH ST 13600 SW 312TH ST CUTLER BAY, FL 33190 HOMESTEAD, FL 33034 HOMESTEAD, FL 33033 TEL: (305) 252-4841 TEL: (305) 246-4607 TEL: (305) 242-6069 HOMESTEAD NUNEZ, EDGARD, MD PHILIPPE, ELIZABETH, MD 810 W MOWRY DR 19300 SW 376TH ST BLANCO, ARMANDO, MD HOMESTEAD, FL 33030 HOMESTEAD, FL 33034 810 W MOWRY DR TEL: (305) 248-4334 TEL: (305) 246-4607 HOMESTEAD, FL 33030 TEL: (305) 248-4334 NUNEZ, EDGARD, MD ROSS, CHARLES, MD 13600 SW 312TH ST 810 W MOWRY DR BLANCO, ARMANDO, MD HOMESTEAD, FL 33033 HOMESTEAD, FL 33030 13600 SW 312TH ST TEL: (305) 242-6069 TEL: (305) 248-4334 HOMESTEAD, FL 33033 TEL: (305) 242-6069 NUNEZ, EDGARD, MD ROSS, CHARLES, MD 19300 SW 376TH ST 13600 SW 312TH ST BLANCO, ARMANDO, MD HOMESTEAD, FL 33034 HOMESTEAD, FL 33033 19300 SW 376TH ST TEL: (305) 246-4607 TEL: (305) 242-6069 HOMESTEAD, FL 33034 TEL: (305) 246-4607 - 4 -