Active NPI
Marc B Klein, DPM
- Sports Medicine Podiatrist
- Boca Raton, FL
National Provider Identifier
1043212566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine Podiatrist
- License
- PO 1505
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 390121101 | Medicaid | FL | |
| 480019906 | Other | FL | RAILROAD MEDICARE |
| 87854X | Other | FL | MEDICARE |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO 1505 | FL | MD | Primary Podiatric Medicine Podiatrist |
| 1505 | FL | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adnan Shariff, Inc | Podiatrist | Current | Accepting new patients |
| Adnan Shariff, Inc | Podiatrist | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.