Individual provider Active NPI

Mohammad Ali Ansari Lari, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Hollywood, FL
National Provider Identifier
1003894767
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME93157 Issued in FL
Practice address
3501 Johnson St
Hollywood, FL 33021-5421
Phone
(954) 985-5921
Fax
(954) 985-3471
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME93157 FL Primary

Addresses

Primary practice location

3501 Johnson St
Hollywood, FL 33021-5421

Mailing address

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 985-5921

Other identifiers 1

IdentifierTypeStateIssuer
272746300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050816001162 FL Practitioner - Pathology 1052382645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Baylor College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Consultants of South Broward, LLPGroup PAC ID 1557267473, 30 clinicians

Practice addresses (Care Compare)

1901 SW 172 Ave
Miramar, FL 33029-5592
Phone (954) 538-4672

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-2333

3600 Washington St
Hollywood, FL 33021-5421
Phone (954) 265-2333

703 N Flamingo Rd
Pembroke Pines, FL 33028-1006
Phone (954) 430-6889

7800 Sheridan St
Pembroke Pines, FL 33024-2536
Phone (954) 963-8417

Hospital & facility affiliations

  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038
  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
  • Memorial Hospital Pembroke Hospital, Pembroke Pines, FL, CCN 100230
  • Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Consultants of South Broward, LLP Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2005 Accepting new patients

Locations

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1003894767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-985-5921",
            "fax_number": "954-985-3471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-985-5921",
            "fax_number": "954-985-3471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSARI LARI",
        "first_name": "MOHAMMAD",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME93157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272746300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.