Organization Active NPI

Doctor'S Medical Associates LLC

  • Internal Medicine Physician
  • Sunrise, FL
National Provider Identifier
1003300690
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS11008 Issued in FL
Legal business name
DOCTOR'S MEDICAL ASSOCIATES LLC
Practice address
6244 W Oakland Park Blvd
Sunrise, FL 33313-1214
Phone
(754) 216-2715
Fax
(954) 697-0842
NPI assigned
Jun 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Authorized official

Name
Jacqueline David, DONPI 1689975310
Title
Physician
Phone
(954) 562-5541

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X OS11008 FL Primary

Addresses

Primary practice location

6244 W Oakland Park Blvd
Sunrise, FL 33313-1214

Mailing address

6244 W Oakland Park Blvd
Sunrise, FL 33313-1214
Phone (754) 216-2715

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190919000866 FL Part B Supplier - Clinic/Group Practice 4082944905 Receives reassigned benefits from 1 practitioner
Practice locations: Lauderhill, FL; Sunrise, FL

National Provider Directory

National Provider Directory

Locations

6244 W Oakland Park Blvd
Sunrise, FL 33313
Phone (754) 216-2715

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1003300690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6244 W OAKLAND PARK BLVD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333131214",
            "telephone_number": "754-216-2715",
            "fax_number": "954-697-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6244 W OAKLAND PARK BLVD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333131214",
            "telephone_number": "754-216-2715",
            "fax_number": "954-697-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR'S MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-18",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "DAVID",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "954-562-5541",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS11008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.