NPIMap

Organization Active NPI

Advanced Facial Cosmetic & Laser Surgery Center, LLC

Doing business as Ocean Drive Plastic Surgery

  • Plastic Surgery Physician
  • Vero Beach, FL
National Provider Identifier
1003111923
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
ME99004 Issued in FL
Legal business name
ADVANCED FACIAL COSMETIC & LASER SURGERY CENTER, LLC
Doing business as
Ocean Drive Plastic Surgery
Practice address
5070 Highway A1A
Suite a
Vero Beach, FL 32963-1400
Phone
(772) 234-3700
Fax
(772) 234-3770
NPI assigned
Jan 25, 2011
Last updated
Nov 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Authorized official

Name
Dr. Alan J Durkin, MDNPI 1215136767
Title
Owner
Phone
(772) 234-3700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU
MOHS-Micrographic Surgery Physician 207ND0101X NU
Plastic Surgery Physician 208200000X NU
Plastic Surgery Physician 208200000X ME99004 FL Primary
Surgery Physician 208600000X NU
Surgical Oncology Physician 2086X0206X NU

Addresses

Primary practice location

5070 Highway A1A
Suite a
Vero Beach, FL 32963-1400

Mailing address

5070 Highway A1A
Suite a
Vero Beach, FL 32963-1400
Phone (772) 234-3700

Other names 1

  • Ocean Drive Plastic Surgery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110407000146 FL Part B Supplier - Clinic/Group Practice 0244414720 Receives reassigned benefits from 4 practitioners
Practice locations: Vero Beach, FL

National Provider Directory

National Provider Directory

Locations

5070 Highway A1A
Ste A
Vero Beach, FL 32963
Phone (772) 234-3700

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1003111923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5070 HIGHWAY A1A",
            "address_2": "SUITE A",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329631400",
            "telephone_number": "772-234-3700",
            "fax_number": "772-234-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5070 HIGHWAY A1A",
            "address_2": "SUITE A",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329631400",
            "telephone_number": "772-234-3700",
            "fax_number": "772-234-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FACIAL COSMETIC & LASER SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-25",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A",
        "authorized_official_last_name": "DURKIN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-234-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME99004",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ocean Drive Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.