Organization Active NPI

Michael a Flicker DO PA

  • Family Medicine Physician
  • Plantation, FL
National Provider Identifier
1184709016
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS5264 Issued in FL
Legal business name
MICHAEL A FLICKER DO PA
Practice address
9633 W Broward Blvd
Suite #6
Plantation, FL 33324-2332
Phone
(954) 835-0005
Fax
(954) 472-8271
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Authorized official

Name
Michael A Flicker, DONPI 1265419709
Title
President
Phone
(954) 835-0005

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS5264 FL Primary

Addresses

Primary practice location

9633 W Broward Blvd
Suite #6
Plantation, FL 33324-2332

Mailing address

9633 W Broward Blvd
Suite #6
Plantation, FL 33324-2332
Phone (954) 835-0005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070118000383 FL Part B Supplier - Clinic/Group Practice 3870594831 Receives reassigned benefits from 1 practitioner
Practice locations: Plantation, FL

National Provider Directory

National Provider Directory

Locations

817 S University Dr
Ste 120
Plantation, FL 33324
Phone (954) 474-9777

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": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1184709016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9633 W BROWARD BLVD",
            "address_2": "SUITE #6",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242332",
            "telephone_number": "954-835-0005",
            "fax_number": "954-472-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9633 W BROWARD BLVD",
            "address_2": "SUITE #6",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242332",
            "telephone_number": "954-835-0005",
            "fax_number": "954-472-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL A FLICKER DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "FLICKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-835-0005",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS5264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.