Individual provider Active NPI

Itzhak Nir, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Loxahatchee, FL
National Provider Identifier
1124015482
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
ME70544 Issued in FL
Practice address
13005 Southern Blvd
Suite 232
Loxahatchee, FL 33470-9206
Phone
(561) 753-3331
Fax
(561) 753-3823
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X ME70544 FL Primary

Addresses

Primary practice location

13005 Southern Blvd
Suite 232
Loxahatchee, FL 33470-9206

Mailing address

13005 Southern Blvd
Suite 232
Loxahatchee, FL 33470-9206
Phone (561) 753-3331

Other identifiers 1

IdentifierTypeStateIssuer
256013500MedicaidFL

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
I20050409000009 FL Practitioner - Plastic and Reconstructive Surgery 3173560380 Practice locations: Loxahatchee, FL

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Miami, LM Miller School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13005 Southern Blvd
Suite 232
Loxahatchee, FL 33470-9272
Phone (561) 753-3331

Hospital & facility affiliations

  • Wellington Regional Medical Center Hospital, Wellington, FL, CCN 100275

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy13
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME70544FLMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Itzhak Nir MD PA PastSince Jan 1, 1990 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.

Hospital & facility affiliations 1

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": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1124015482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD",
            "address_2": "SUITE 232",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709206",
            "telephone_number": "561-753-3331",
            "fax_number": "561-753-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD",
            "address_2": "SUITE 232",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709206",
            "telephone_number": "561-753-3331",
            "fax_number": "561-753-3823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIR",
        "first_name": "ITZHAK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME70544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256013500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loxahatchee, FL

Sources for this page

Verify at the official NPI Registry.