Shahrad Mabourakh, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0067283 Issued in FL

Practice address

6451 W Commercial Blvd
Tamarac, FL 33319-2110

Phone

(954) 720-1414

Fax

(954) 720-4727

NPI assigned

Mar 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

Temple University School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

West Broward Internal Medicine, PLLCGroup PAC ID 1951470970, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
• Westside Regional Medical Center Hospital, Plantation, FL, CCN 100228
• Tamarac Center for Rehabilitation and Healing Nursing home, Tamarac, FL, CCN 105360

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GEDBCA

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.

• West Broward Internal Medicine LLC

  • Internal Medicine Physician
  • Tamarac, FL
  • NPI 1871765727
  Medicare reassignment Care Compare group NPD Authorized official
• Florida Institute of Health LTD LLLP

  • Diagnostic Radiology Physician
  • Lauderdale Lakes, FL
  • NPI 1851352769
  NPD (past)

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

• Columbia Hospital Corporation of South Broward

  dba HCA Florida Westside Hospital

  • General Acute Care Hospital
  • Plantation, FL
  • NPI 1063466589
  Care Compare affiliation
• Tamarac Rehabilitation & Health Center Inc

  dba Tamarac Rehabilitation & Health Center

  • Nursing Facility/Intermediate Care Facility
  • Tamarac, FL
  • NPI 1346264785

  Nursing home

  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Boynton Beach, FL
  • NPI 1467507657
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Miami Lakes, FL
  • NPI 1528113792
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Melbourne, FL
  • NPI 1669548053
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Tallahassee, FL
  • NPI 1972555464
  Care Compare affiliation

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1053388090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 W COMMERCIAL BLVD",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333192110",
            "telephone_number": "954-720-1414",
            "fax_number": "954-720-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 W COMMERCIAL BLVD",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333192110",
            "telephone_number": "954-720-1414",
            "fax_number": "954-720-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABOURAKH",
        "first_name": "SHAHRAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0067283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea J Lozada
• Lucette Eleonor Luces Manocchio
• Olivia Lumibao
• Lymphatx Inc
• Mabel Hernandezmdpa
• Alberto Macena, NP-C
• Diana Fernanda Machuca Suarez, APRN
• Madelyn B Lipman MD PA
• Madrid, LLC (Florida Open MRI)
• Yessica Madrid

• Internal Medicine Physician in Tamarac, FL
• Providers in Tamarac, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.