Individual provider Active NPI

Stuart George Moraitis, DDS

  • General Practice Dentistry
  • Ft Lauderdale, FL
National Provider Identifier
1063630598
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 6929 Issued in FL
Practice address
1101 E Broward Blvd
Ft Lauderdale, FL 33301-2011
Phone
(954) 524-0577
Fax
(954) 524-0537
NPI assigned
Apr 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 6929 FL Primary

Addresses

Primary practice location

1101 E Broward Blvd
Ft Lauderdale, FL 33301-2011

Mailing address

1101 E Broward Blvd
Ft Lauderdale, FL 33301-2011
Phone (954) 524-0577

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240125001086 FL Order and Referring Only - DentistPractitioner - Dentist 7719280338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 6929FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Stuart G. Moraitis DDS PA General Practice Past Accepting new patients

Organizations & group practices 1

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": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063630598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 E BROWARD BLVD",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012011",
            "telephone_number": "954-524-0577",
            "fax_number": "954-524-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E BROWARD BLVD",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012011",
            "telephone_number": "954-524-0577",
            "fax_number": "954-524-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAITIS",
        "first_name": "STUART",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 6929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.