NPIMap

Organization Active NPI

Mason Hershorin MSN Arnp Inc.

  • Nurse Practitioner
  • Davie, FL
National Provider Identifier
1174601041
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MASON HERSHORIN MSN ARNP INC.
Practice address
4217 SW 64TH Ave
Davie, FL 33314-3446
Phone
(954) 444-7661
Fax
(954) 430-3261
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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

Authorized official

Name
Mason P Hershorin, ARNPNPI 1649201401
Title
Owner/President
Phone
(954) 444-7661

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
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

4217 SW 64TH Ave
Davie, FL 33314-3446

Mailing address

311 SW 99TH Ter
Pembroke Pines, FL 33025-1065
Phone (954) 444-7661

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070522000284 FL Part B Supplier - Clinic/Group Practice 4789685777 Receives reassigned benefits from 4 practitioners
Practice locations: Miami, FL; Cape Coral, FL; Davie, FL

National Provider Directory

National Provider Directory

Locations

4801 S University Dr
Ste 217
Davie, FL 33328
Phone (954) 432-1812

4217 SW 64th Ave
Davie, FL 33314
Phone (954) 444-7661

12505 NE 16th Ave
North Miami, FL 33161
Phone (305) 891-1210

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354492800000",
    "number": "1174601041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 SW 99TH TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330251065",
            "telephone_number": "954-444-7661",
            "fax_number": "954-430-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4217 SW 64TH AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333143446",
            "telephone_number": "954-444-7661",
            "fax_number": "954-430-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASON HERSHORIN MSN ARNP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-12-03",
        "status": "A",
        "authorized_official_last_name": "HERSHORIN",
        "authorized_official_first_name": "MASON",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "954-444-7661",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.