Individual provider Active NPI

Daniel Marc Tuckerman, D.O.

  • Internal Medicine Physician
  • Hialeah, FL
National Provider Identifier
1164957478
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS15636 Issued in FL
Practice address
2001 W 68TH St
Suite 202
Hialeah, FL 33016-1801
Phone
(305) 364-2107
NPI assigned
Apr 24, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS15636 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2001 W 68TH St
Suite 202
Hialeah, FL 33016-1801

Mailing address

210 Bal Cross Dr
Bal Harbour, FL 33154-1319

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
I20200123000438 FL Practitioner - Internal Medicine 3577834944 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Collins Physician Services, LLCGroup PAC ID 9234476920, 48 clinicians

Practice addresses (Care Compare)

4300 Alton Rd
Miami, FL 33140-2948
Phone (305) 481-9776

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Pensacola LLC Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Collins Physician Services, LLC Internal Medicine CurrentSince Jul 13, 2023 Accepting new patients
South Miami Inpatient Physicians Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
Cogent Healthcare of Pensacola LLC Internal Medicine Current Accepting new patients
MD Now Medical Centers Inc CurrentSince Nov 30, 2019 Accepting new patients
MD Now Medical Centers Inc CurrentSince Nov 30, 2019 Accepting new patients
Cogent Healthcare of Pensacola LLC Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
QMC LLC PastSince Feb 1, 2021 Accepting new patients

Locations

17240 Cortez Blvd
Brooksville, FL 34601
Phone (352) 544-6060

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

1500 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-4410

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

2750 Coral Way
Miami, FL 33145
Phone (305) 569-9942

4300 Alton Rd
Miami Beach, FL 33140
Phone (305) 481-9776

1770 NE Miami Gardens Dr
North Miami Beach, FL 33179
Phone (305) 949-4141

8201 W Broward Blvd
Plantation, FL 33324
Phone (954) 476-3900

6200 SW 73rd St
South Miami, FL 33143
Phone (305) 661-4611

6200 SW 73rd St
#69
South Miami, FL 33143
Phone (786) 662-4000

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409

Organizations & group practices 8

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 2

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1164957478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 BAL CROSS DR",
            "city": "BAL HARBOUR",
            "state": "FL",
            "postal_code": "331541319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 68TH ST",
            "address_2": "SUITE 202",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161801",
            "telephone_number": "305-364-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKERMAN",
        "first_name": "DANIEL",
        "middle_name": "MARC",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-24",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS15636",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.