Individual provider Active NPI

Phi-Van T Le, MD

  • Dermatology Physician
  • Pembroke Pines, FL
National Provider Identifier
1063462463
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME63957 Issued in FL
Practice address
603 N Flamingo Rd
Ste 350
Pembroke Pines, FL 33028-1013
Phone
(954) 435-5100
Fax
(954) 435-5816
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME63957 FL Primary

Addresses

Primary practice location

603 N Flamingo Rd
Ste 350
Pembroke Pines, FL 33028-1013

Mailing address

603 N Flamingo Rd
Ste 350
Pembroke Pines, FL 33028-1013
Phone (954) 435-5100

Other identifiers 1

IdentifierTypeStateIssuer
372801300MedicaidFL

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
I20100510000389 FL Practitioner - Dermatology 2567462989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Florida College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

603 N Flamingo Rd
Suite 350
Pembroke Pines, FL 33028-1013
Phone (954) 435-5100

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision75
Removal of skin lesions1042
Removal or shaving of skin growth59
Skin biopsy269

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME63957FLMDDermatology Physician
63957FLMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Aqua Dermatology of Florida, PA Dermatology CurrentSince May 8, 2017 Accepting new patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince May 8, 2017 Accepting new patients

Locations

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

603 N Flamingo Rd
Ste 350
Pembroke Pnes, FL 33028
Phone (954) 435-5100

2625 Executive Park Dr
Ste 7
Weston, FL 33331
Phone (954) 385-1544

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: lephivan@aquadermatology.emadirect.md

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1063462463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 N FLAMINGO RD",
            "address_2": "STE 350",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281013",
            "telephone_number": "954-435-5100",
            "fax_number": "954-435-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 N FLAMINGO RD",
            "address_2": "STE 350",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281013",
            "telephone_number": "954-435-5100",
            "fax_number": "954-435-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "PHI-VAN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME63957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372801300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.