Organization Active NPI

Vincent Pianelli, Mdpa

  • Internal Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1194979963
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0014100 Issued in FL
Legal business name
VINCENT PIANELLI, MDPA
Practice address
935 Intracoastal Drive
Fort Lauderdale, FL 33304
Phone
(954) 522-8561
Fax
(954) 522-6602
NPI assigned
Nov 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Authorized official

Name
George G Boctor, MD
Title
Owner
Phone
(954) 776-1180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME0014100 FL Primary

Addresses

Primary practice location

935 Intracoastal Drive
Fort Lauderdale, FL 33304

Mailing address

PO Box 23158
Fort Lauderdale, FL 33307-3158
Phone (954) 522-8561

Other identifiers 2

IdentifierTypeStateIssuer
048950600MedicaidFL
06830OtherFLMEDICARE ID

Other names 1

  • Vincent Pianelli, M.D. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090323000090 FL Part B Supplier - Clinic/Group Practice 0648336453 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Lauderdale, FL

National Provider Directory

National Provider Directory

Locations

918 NE 26th Ave
Ft Lauderdale, FL 33304
Phone (954) 522-8561

Practitioners & affiliated clinicians

Practitioners 2

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": "1225929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1194979963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23158",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333073158",
            "telephone_number": "954-522-8561",
            "fax_number": "954-522-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 INTRACOASTAL DRIVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33304",
            "telephone_number": "954-522-8561",
            "fax_number": "954-522-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINCENT PIANELLI, MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-06",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "BOCTOR",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-776-1180",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0014100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048950600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "06830",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vincent Pianelli, M.D.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vincent Pianelli, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 25, 2023; 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.