Organization Active NPI

Jan Pavlinec M.D., P.a.

  • Legal Medicine
  • Pompano Beach, FL
National Provider Identifier
1124382940
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
MEO38469 Issued in FL
Legal business name
JAN PAVLINEC M.D., P.A.
Practice address
1161 SE 22ND Ave
Pompano Beach, FL 33062-7045
Phone
(954) 785-7343
Fax
(954) 785-4636
NPI assigned
Jun 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Authorized official

Name
Dr. Jan Pavlinec, M.D.NPI 1801981303
Title
President
Phone
(954) 801-2398

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X MEO38469 FL Primary

Addresses

Primary practice location

1161 SE 22ND Ave
Pompano Beach, FL 33062-7045

Mailing address

1161 SE 22ND Ave
Pompano Beach, FL 33062-7045
Phone (954) 785-7343

Other identifiers 1

IdentifierTypeStateIssuer
062051300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120924000758 FL Part B Supplier - Clinic/Group Practice 6800044462 Receives reassigned benefits from 1 practitioner
Practice locations: Pompano Beach, FL

National Provider Directory

National Provider Directory

Locations

1161 SE 22nd Ave
Pompano Beach, FL 33062
Phone (954) 785-7343

Practitioners & affiliated clinicians

Practitioners 1

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": "1340668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340668800000",
    "number": "1124382940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 SE 22ND AVE",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330627045",
            "telephone_number": "954-785-7343",
            "fax_number": "954-785-4636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 SE 22ND AVE",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330627045",
            "telephone_number": "954-785-7343",
            "fax_number": "954-785-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAN PAVLINEC M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-26",
        "last_updated": "2012-06-26",
        "status": "A",
        "authorized_official_last_name": "PAVLINEC",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-801-2398",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "FL",
            "license": "MEO38469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062051300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.