Individual provider Active NPI

Ihsane Ouansafi

  • Anatomic Pathology & Clinical Pathology Physician
  • Pembroke Pines, FL
National Provider Identifier
1104069558
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME110265 Issued in FL
Practice address
703 N Flamingo Rd
Pembroke Pines, FL 33028-1006
Phone
(954) 844-7881
NPI assigned
Apr 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Pathology) Physician 207ZH0000X ME110265 FL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME110265 FL Primary

Addresses

Primary practice location

703 N Flamingo Rd
Pembroke Pines, FL 33028-1006

Mailing address

3877 San Simeon Cir
Weston, FL 33331-5056
Phone (646) 280-6404

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
I20111229000461 FL Practitioner - Pathology 1658547302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Consultants of South Broward, LLPGroup PAC ID 1557267473, 30 clinicians

Practice addresses (Care Compare)

1901 SW 172 Ave
Miramar, FL 33029-5592
Phone (954) 538-4672

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-2333

3600 Washington St
Hollywood, FL 33021-5421
Phone (954) 265-2333

703 N Flamingo Rd
Pembroke Pines, FL 33028-1006
Phone (954) 430-6889

7800 Sheridan St
Pembroke Pines, FL 33024-2536
Phone (954) 963-8417

Hospital & facility affiliations

  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038
  • Memorial Hospital Pembroke Hospital, Pembroke Pines, FL, CCN 100230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME110265FLMDHematology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Consultants of South Broward, LLP Anatomic Pathology & Clinical Pathology CurrentSince Aug 8, 2011 Accepting new patients

Locations

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

703 N Flamingo Rd
Pembroke Pnes, FL 33028
Phone (954) 436-5000

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1104069558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3877 SAN SIMEON CIR",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333315056",
            "telephone_number": "646-280-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281006",
            "telephone_number": "954-844-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUANSAFI",
        "first_name": "IHSANE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-15",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "FL",
            "license": "ME110265",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME110265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.