Fort Lauderdale Medical Surgical Associates., Inc.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

OS8504 Issued in FL

Legal business name

FORT LAUDERDALE MEDICAL SURGICAL ASSOCIATES., INC.

Practice address

2301 Wilton Dr
Suite C2
Wilton Manors, FL 33305-1202

Phone

(954) 567-5898

Fax

(954) 567-0395

NPI assigned

Nov 6, 2012

Organization subpart

No

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

Authorized official

Name

Timothy Goshen, DONPI 1083665723

Title

Owner

Phone

(954) 567-5898

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Timothy R Goshen, D.O.

  • Specialist
  • Wilton Manors, FL
  • NPI 1083665723
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1134473663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 WILTON DR",
            "address_2": "SUITE C2",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051202",
            "telephone_number": "954-567-5898",
            "fax_number": "954-567-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 WILTON DR",
            "address_2": "SUITE C2",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051202",
            "telephone_number": "954-567-5898",
            "fax_number": "954-567-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT LAUDERDALE MEDICAL SURGICAL ASSOCIATES., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "GOSHEN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-567-5898",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "OS8504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266516600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "57739",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shane A Fisher, DDS
• Florida Institute for Recovery and Sex Therapy
• Florida Institute of Health LTD LLLP
• Fort Lauderdale Couples, Family & Individual Therapy
• Fort Lauderdale Couples, Family and Individual Therapy, LLC
• James Foster, ARNP
• Bonnie J Fraley, LMHC
• Kathy Lucia Francis, M.S.W.
• Icaro Franco
• Jarrod Frazier

• Colon & Rectal Surgery Physician in Wilton Manors, FL
• Providers in Wilton Manors, FL by specialty
• Colon & Rectal Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.