NPIMap

Organization Active NPI

North Broward Hospital District

  • Family Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1104984533
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTH BROWARD HOSPITAL DISTRICT
Practice address
2866 E Oakland Park Blvd Ste 3
Fort Lauderdale, FL 33306-1819
Phone
(954) 491-8676
Fax
(954) 494-5994
NPI assigned
Dec 5, 2006
Organization subpart
Yes
Parent organization
NORTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Alisa Bert
Title
Cfo
Phone
(954) 847-4117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2866 E Oakland Park Blvd Ste 3
Fort Lauderdale, FL 33306-1819

Mailing address

1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 491-8676

Other identifiers 2

IdentifierTypeStateIssuer
253794030MedicaidFL
00020OtherFLBCBS

Other names 2

  • BH Physcians Imperial Point Doing business as
  • BHPG IP 2866 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
Robert L Odell MD140 organizations share this tax ID, including this one
Part of
Robert L Odell MD

Organizations with this tax ID in the same state 22

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

View all 22

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1104984533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-491-8676",
            "fax_number": "954-491-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2866 E OAKLAND PARK BLVD STE 3",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061819",
            "telephone_number": "954-491-8676",
            "fax_number": "954-494-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "enumeration_date": "2006-12-05",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "BERT",
        "authorized_official_first_name": "ALISA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "954-847-4117"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253794030",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00020",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BH Physcians Imperial Point",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BH Physcians Imperial Point",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHPG IP 2866 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 Oct 16, 2024; 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.