Individual provider Active NPI

Jeffrey P Brosco, MD, PHD

  • Developmental - Behavioral Pediatrics Physician
  • Miami, FL
National Provider Identifier
1144283045
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
ME68050 Issued in FL
Practice address
1150 NW 14TH St
Miami, FL 33136-2137
Phone
(305) 270-5050
Fax
(305) 270-3846
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X ME68050 FL Primary

Addresses

Primary practice location

1150 NW 14TH St
Miami, FL 33136-2137

Mailing address

1475 NW 12TH Ave
Box 016960 M851
Miami, FL 33136-1002
Phone (305) 243-7249

Other identifiers 1

IdentifierTypeStateIssuer
3781356-00MedicaidFL

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
I20101209000185 FL Practitioner - Pediatric Medicine 0446274237 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami CurrentSince Jan 1, 2020 Accepting new patients
University of Miami Current Accepting new patients
University of Miami Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1150 NW 14th St
Miami, FL 33136
Phone (305) 243-6165

8932 SW 97th Ave
Miami, FL 33176
Phone (305) 270-3485

15255 SW 137th Ave
Miami, FL 33177
Phone (305) 233-8499

1475 NW 12th Ave
#16960
Miami, FL 33136
Phone (305) 243-6802

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1601 NW 12th Ave
Fl 1
Miami, FL 33136
Phone (305) 243-3166

Interoperability endpoints

  • Direct secure messaging: jbrosco4827@direct.med.miami.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1144283045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 NW 12TH AVE",
            "address_2": "BOX 016960 M851",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361002",
            "telephone_number": "305-243-7249",
            "fax_number": "305-243-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 NW 14TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331362137",
            "telephone_number": "305-270-5050",
            "fax_number": "305-270-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSCO",
        "first_name": "JEFFREY",
        "middle_name": "P",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "FL",
            "license": "ME68050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3781356-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.