Individual provider Active NPI

Anthony P Previte, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Fort Lauderdale, FL
National Provider Identifier
1063430254
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
ME41525 Issued in FL
Practice address
1820 E Commercial Blvd
Fort Lauderdale, FL 33308-3725
Phone
(954) 202-0205
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X ME41525 FL Primary

Addresses

Primary practice location

1820 E Commercial Blvd
Fort Lauderdale, FL 33308-3725

Mailing address

1820 E Commercial Blvd
Fort Lauderdale, FL 33308-3725
Phone (954) 202-0205

Other identifiers 1

IdentifierTypeStateIssuer
068003699MedicaidFL

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031219000470 FL Practitioner - Family PracticePractitioner - Geriatric Medicine 2769380492 Practice locations: Ft Lauderdale, FL; Wilton Manors, FL; Sunrise, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1063430254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 E COMMERCIAL BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083725",
            "telephone_number": "954-202-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 E COMMERCIAL BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083725",
            "telephone_number": "954-202-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREVITE",
        "first_name": "ANTHONY",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME41525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068003699",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.