NPIMap

Organization Active NPI

North Broward Hospital District

Doing business as BH Physicians Main

  • Internal Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1073884417
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTH BROWARD HOSPITAL DISTRICT
Doing business as
BH Physicians Main
BHPG Mob 1625 PCP
Practice address
1625 SE 3Rd Ave Ste 721
Fort Lauderdale, FL 33316-2521
Phone
(954) 355-4617
Fax
(954) 355-4618
NPI assigned
Jan 17, 2012
Last updated
Jun 24, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Authorized official

Name
Krystle Martin
Title
Cfo
Phone
(954) 473-7420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

1625 SE 3Rd Ave Ste 721
Fort Lauderdale, FL 33316-2521

Mailing address

1608 SE 3Rd Ave FL 3
Fort Lauderdale, FL 33316-2564
Phone (954) 355-4617

Other identifiers 2

IdentifierTypeStateIssuer
263310808MedicaidFL
00020OtherFLBCBS

Other names 2

  • BH Physicians Main Doing business as
  • BHPG MOB 1625 PCP Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001860 FL Part B Supplier - Clinic/Group Practice 3577472422 Receives reassigned benefits from 251 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
N Btroward Hospital Dis140 organizations share this tax ID, including this one
Part of
N Btroward Hospital Dis

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782259200000",
    "number": "1073884417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 SE 3RD AVE FL 3",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162564",
            "telephone_number": "954-355-4617",
            "fax_number": "954-355-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SE 3RD AVE STE 721",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162521",
            "telephone_number": "954-355-4617",
            "fax_number": "954-355-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "enumeration_date": "2012-01-17",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KRYSTLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "954-473-7420"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263310808",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00020",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BH Physicians Main",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BH Physicians Main",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHPG MOB 1625 PCP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.