Individual provider Active NPI

Larrye Michael Feldman, DO

  • Internal Medicine Physician
  • Hollywood, FL
National Provider Identifier
1013991074
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS0003209 Issued in FL
Practice address
3389 Sheridan St
Box #204
Hollywood, FL 33021-3606
Phone
(954) 240-0813
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS0003209 FL Primary

Addresses

Primary practice location

3389 Sheridan St
Box #204
Hollywood, FL 33021-3606

Mailing address

3389 Sheridan St
Box #204
Hollywood, FL 33021-3606
Phone (954) 240-0813

Other identifiers 2

IdentifierTypeStateIssuer
036483500MedicaidFL
OS0003209OtherFLLICENSE STATE OF FLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3209FLMDAcupuncturist
OS0003209FLMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1013991074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3389 SHERIDAN ST",
            "address_2": "BOX #204",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213606",
            "telephone_number": "954-240-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3389 SHERIDAN ST",
            "address_2": "BOX #204",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213606",
            "telephone_number": "954-240-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDMAN",
        "first_name": "LARRYE",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS0003209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036483500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE STATE OF FLA",
            "identifier": "OS0003209",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.