Active NPI
Mitchell J Flaxman, M.D.
- Gastroenterology Physician
- Jupiter, FL
National Provider Identifier
1104908797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- ME0046424
- Practice address
- 1002 S Old Dixie Hwy
Suite 201
Jupiter, FL 33458-7202 - Phone
- (561) 744-2200
- Fax
- (561) 744-3083
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | ME0046424 | FL | Primary |
Addresses
Primary practice location
1002 S Old Dixie Hwy
Suite 201
Jupiter, FL 33458-7202
Mailing address
5431 N University Dr
Coral Springs, FL 33067-4639
Phone (954) 344-2522
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03879 | Other | FL | BC/BS INDIV PROVIDER NUM |
| 99485 | Other | FL | BC/BS GROUP PROVIDER NUM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0046424 | FL | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gastrocare LLP | Gastroenterology | 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.
-
- Gastroenterology Physician
- Coral Springs, FL
- NPI 1801828660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1104908797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5431 N UNIVERSITY DR",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330674639",
"telephone_number": "954-344-2522",
"fax_number": "954-344-9189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 S OLD DIXIE HWY",
"address_2": "SUITE 201",
"city": "JUPITER",
"state": "FL",
"postal_code": "334587202",
"telephone_number": "561-744-2200",
"fax_number": "561-744-3083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLAXMAN",
"first_name": "MITCHELL",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "ME0046424",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS INDIV PROVIDER NUM",
"identifier": "03879",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS GROUP PROVIDER NUM",
"identifier": "99485",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jupiter, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.