Individual provider Active NPI

Nina Joy Pearlmutter, MD

  • Internal Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1205870185
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME034447 Issued in FL
Practice address
15814 West State Road 84
Fort Lauderdale, FL 33326
Phone
(954) 384-7200
Fax
(954) 389-9019
NPI assigned
Jun 15, 2006
Last updated
Jul 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME034447 FL Primary

Addresses

Primary practice location

15814 West State Road 84
Fort Lauderdale, FL 33326

Mailing address

1040 SW 75TH Ave
Plantation, FL 33317

Other identifiers 2

IdentifierTypeStateIssuer
065825100MedicaidFL
160624900OtherUS DEPT OF LABOR

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
I20031215000702 FL Practitioner - Internal Medicine 0749187185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Miami, LM Miller School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15814 W State Rd
Suite 84
Fort Lauderdale, FL 33326
Phone (954) 384-7200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME034447FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westgate Medical Center, Inc Internal Medicine CurrentSince Jul 1, 1966 Accepting new patients

Locations

15814 W State Road 84
Sunrise, FL 33326
Phone (954) 384-1747

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1205870185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SW 75TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "33317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15814 WEST STATE ROAD 84",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33326",
            "telephone_number": "954-384-7200",
            "fax_number": "954-389-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARLMUTTER",
        "first_name": "NINA",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME034447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065825100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "160624900",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.