Individual provider Active NPI

Marc B Klein, DPM

  • Sports Medicine Podiatrist
  • Boca Raton, FL
National Provider Identifier
1043212566
Registry record updated Apr 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine PodiatristTaxonomy code 213ES0000X
License
PO 1505 Issued in FL
Practice address
7050 W Palmetto Park Rd
Suite #18
Boca Raton, FL 33433-3426
Phone
(561) 447-7571
Fax
(561) 447-7574
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO 1505 FL
Primary Podiatric Medicine Podiatrist 213EP1101X PO 1505 FL
Sports Medicine Podiatrist 213ES0000X PO 1505 FL Primary
Foot Surgery Podiatrist 213ES0131X PO 1505 FL

Addresses

Primary practice location

7050 W Palmetto Park Rd
Suite #18
Boca Raton, FL 33433-3426

Mailing address

7050 W Palmetto Park Rd
Suite #18
Boca Raton, FL 33433-3426
Phone (561) 447-7571

Other identifiers 3

IdentifierTypeStateIssuer
390121101MedicaidFL
480019906OtherFLRAILROAD MEDICARE
87854XOtherFLMEDICARE

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071031000303 FL Practitioner - Podiatry 1052408564 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO 1505FLMDPrimary Podiatric Medicine Podiatrist
1505FLMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Adnan Shariff, Inc Podiatrist CurrentSince Jul 30, 2021 Accepting new patients
Adnan Shariff, Inc Podiatrist CurrentSince Jul 30, 2021 Accepting new patients

Locations

7050 W Palmetto Park Rd
Ste 18
Boca Raton, FL 33433
Phone (561) 391-8366

235 NE 19th Dr
Okeechobee, FL 34972
Phone (863) 357-1166

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270425600000",
    "number": "1043212566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 W PALMETTO PARK RD",
            "address_2": "SUITE #18",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333426",
            "telephone_number": "561-447-7571",
            "fax_number": "561-447-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 W PALMETTO PARK RD",
            "address_2": "SUITE #18",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333426",
            "telephone_number": "561-447-7571",
            "fax_number": "561-447-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "MARC",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2010-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO 1505",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": "PO 1505",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "FL",
            "license": "PO 1505",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO 1505",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390121101",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480019906",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "87854X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.