Individual provider Active NPI

Joel Sandberg, M.D.

  • Ophthalmology Physician
  • Hollywood, FL
National Provider Identifier
1073500484
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME0024544 Issued in FL
Practice address
300 S Park Rd Ste 300
Hollywood, FL 33021-8353
Phone
(954) 925-2740
Fax
(954) 923-8379
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME0024544 FL Primary

Addresses

Primary practice location

300 S Park Rd Ste 300
Hollywood, FL 33021-8353

Mailing address

300 S Park Rd Ste 300
Hollywood, FL 33021-8353
Phone (954) 925-2740

Other identifiers 1

IdentifierTypeStateIssuer
035382500MedicaidFL

Other names 1

  • Dr. Joel Sandberg Professional name

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
I20101008000470 FL Practitioner - Ophthalmology 6608998919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0024544FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Surgery Associates LLC CurrentSince Aug 1, 1972 Accepting new patients
Eye Surgery Associates LLC Ophthalmology CurrentSince Aug 1, 1972 Accepting new patients

Locations

2740 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 334-3124

300 S Park Rd
Ste 300
Hollywood, FL 33021
Phone (954) 925-2740

900 NW 17th St
Miami, FL 33136
Phone (305) 243-6605

2300 N Commerce Pkwy
Ste 307
Weston, FL 33326
Phone (954) 217-3155

Interoperability endpoints

  • Direct secure messaging: joel.sandberg.p3@direct.drea.nextgenshare.com

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1073500484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S PARK RD STE 300",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218353",
            "telephone_number": "954-925-2740",
            "fax_number": "954-923-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S PARK RD STE 300",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218353",
            "telephone_number": "954-925-2740",
            "fax_number": "954-923-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDBERG",
        "first_name": "JOEL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0024544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035382500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOEL",
            "last_name": "SANDBERG",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.