Individual provider Active NPI

John Michael Thomassen, M.D.

  • Plastic Surgery Physician
  • Ft Lauderdale, FL
National Provider Identifier
1104835925
Registry record updated Mar 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
ME 95272 Issued in FL
Practice address
2800 E Commercial Blvd
Suite 103
Ft Lauderdale, FL 33308-4229
Phone
(954) 771-0200
Fax
(954) 208-5171
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X ME 95272 FL Primary
Plastic Surgery Physician 208200000X MD 33673 DC
Plastic Surgery Physician 208200000X 0101231653 VA

Addresses

Primary practice location

2800 E Commercial Blvd
Suite 103
Ft Lauderdale, FL 33308-4229

Mailing address

2800 E Commercial Blvd
Suite 103
Ft Lauderdale, FL 33308-4229
Phone (954) 771-0200

Other identifiers 1

IdentifierTypeStateIssuer
276131900MedicaidFL

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
I20070307000206 FL Practitioner - Plastic and Reconstructive Surgery 7113020447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Puerto Rico School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2800 E Commercial Blvd
Suite 103
Fort Lauderdale, FL 33308-4202
Phone (803) 807-2844

Hospital & facility affiliations

  • Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 33673DCMDPlastic Surgery Physician
ME 95272FLMDPlastic Surgery Physician
0101231653VAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Michael Thomassen MD PA Plastic Surgery CurrentSince Jan 3, 2007 Accepting new patients

Locations

2800 E Commercial Blvd
Ste 103
Ft Lauderdale, FL 33308
Phone (803) 807-2844

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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 4

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1104835925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E COMMERCIAL BLVD",
            "address_2": "SUITE 103",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084229",
            "telephone_number": "954-771-0200",
            "fax_number": "954-208-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E COMMERCIAL BLVD",
            "address_2": "SUITE 103",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084229",
            "telephone_number": "954-771-0200",
            "fax_number": "954-208-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMASSEN",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME 95272",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "DC",
            "license": "MD 33673",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "VA",
            "license": "0101231653",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276131900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.