Active NPI
Donald Sprague Pender
- Radiological Physics Physician
- Tamarac, FL
National Provider Identifier
1053664615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiological Physics Physician
- License
- TRP143
- Practice address
- 3920 NW 49TH St
Tamarac, FL 33309-3308 - Phone
- (954) 730-2333
- Fax
- (954) 730-2337
- NPI assigned
- Oct 19, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiological Physics Physician | 2085R0205X | TRP143 | FL | Primary |
Addresses
Primary practice location
3920 NW 49TH St
Tamarac, FL 33309-3308
Mailing address
390 NE 93Rd St
Miami Shores, FL 33138-2828
Phone (786) 298-6639
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TRP143 | FL | MD | Radiological Physics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Horizon Medical Services,LLC | Past | Accepting new patients | |
| Mark E Pomper MD PA | Past | Accepting new patients |
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.
-
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350604800000",
"number": "1053664615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 NE 93RD ST",
"city": "MIAMI SHORES",
"state": "FL",
"postal_code": "331382828",
"telephone_number": "786-298-6639",
"fax_number": "954-730-2337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3920 NW 49TH ST",
"city": "TAMARAC",
"state": "FL",
"postal_code": "333093308",
"telephone_number": "954-730-2333",
"fax_number": "954-730-2337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENDER",
"first_name": "DONALD",
"middle_name": "SPRAGUE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-19",
"last_updated": "2012-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0205X",
"taxonomy_group": "",
"desc": "Radiology, Radiological Physics",
"state": "FL",
"license": "TRP143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tamarac, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.