Active NPI
Celso Agner, M.D., MSC
- Vascular Neurology Physician
- Fort Lauderdale, FL
National Provider Identifier
1194728964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Neurology Physician
- License
- ME 117153
- Practice address
- 1625 SE 3Rd Avenue
Suite 623
Fort Lauderdale, FL 33316-2521 - Phone
- (954) 320-3322
- Fax
- (954) 462-7410
- NPI assigned
- May 24, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 28
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Neurology
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Broward Hospital District
Practice addresses (Care Compare)
1625 SE 3 Ave
Fort Lauderdale, FL 33316-2521
Phone (954) 320-3322
Hospital & facility affiliations
- Broward Health Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140422000460 | FL | Practitioner - Neurology | 5698799732 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-116408 | IL | MD | Neurology Physician |
| ME 117153 | FL | MD | Vascular Neurology Physician |
Practice roles (6 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Broward Hospital District | Current | Accepting new patients | |
| North Broward Hospital District | Current |
Accepting new patients | |
| North Broward Hospital District | Current |
Accepting new patients | |
| Nuvance Health Medical Practice PC | Past | Accepting new patients | |
| North Broward Hospital District | Past | Accepting new patients | |
| Eriver Neurology of New York. LLC | Neurology | Past |
Accepting new patients |
Locations
1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000
1625 SE 3rd Ave
Ste 623
Ft Lauderdale, FL 33316
Phone (954) 320-3322
1700 NW 49th St
Ste 125
Ft Lauderdale, FL 33309
Phone (954) 355-3490
Networks
- Freedom Health HMO Network
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HJIAAA
Specialties & licenses 3
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 227395 | NY | |
| Neurology Physician | 2084N0400X | 036-116408 | IL | |
| Vascular Neurology Physician | 2084V0102X | ME 117153 | FL | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
1625 SE 3Rd Avenue
Suite 623
Fort Lauderdale, FL 33316-2521
Mailing address
1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3763
Other identifiers 4
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14U19 | Other | FL | FLORIDA BLUE (BCBS) |
| 010834000 | Medicaid | FL | |
| 02408684 | Medicaid | NY | |
| 695540001 | Other | IL | PTAN |
Other names 1
NPPES NPI Registry- Dr. Celso Agner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 1, 2024.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1194728964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 NW 49TH ST STE 125",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333093763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1625 SE 3RD AVENUE",
"address_2": "SUITE 623",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333162521",
"telephone_number": "954-320-3322",
"fax_number": "954-462-7410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGNER",
"first_name": "CELSO",
"name_prefix": "Dr.",
"credential": "M.D., MSC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2024-04-01",
"certification_date": "2023-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "227395",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": "036-116408",
"primary": false
},
{
"code": "2084V0102X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Vascular Neurology",
"state": "FL",
"license": "ME 117153",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA BLUE (BCBS)",
"identifier": "14U19",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010834000",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02408684",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "695540001",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CELSO",
"last_name": "AGNER",
"prefix": "DR.",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.