Individual provider Active NPI

Myron Tanenbaum, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Miami, FL
National Provider Identifier
1225091473
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
41105 Issued in FL
Practice address
7765 SW 87TH Ave
Suite 210
Miami, FL 33173-2596
Phone
(305) 273-5353
Fax
(305) 273-0496
NPI assigned
Apr 10, 2006
Last updated
May 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0041105 FL
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X 41105 FL Primary

Addresses

Primary practice location

7765 SW 87TH Ave
Suite 210
Miami, FL 33173-2596

Mailing address

7765 SW 87TH Ave
Suite 210
Miami, FL 33173-2596
Phone (305) 273-5353

Other identifiers 1

IdentifierTypeStateIssuer
0489972-00MedicaidFL

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
I20100914000111 FL Practitioner - Ophthalmology 4880719905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Washington University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7765 SW 87 Ave
Suite 210
Miami, FL 33173-2586
Phone (305) 273-5353

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0041105FLMDOphthalmology Physician
41105FLMDOphthalmic Plastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Myron Tanenbaum MD PA Ophthalmology CurrentSince Oct 18, 1982 Accepting new patients

Locations

7765 SW 87th Ave
Ste 210
Miami, FL 33173
Phone (305) 273-5353

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1225091473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7765 SW 87TH AVE",
            "address_2": "SUITE 210",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331732596",
            "telephone_number": "305-273-5353",
            "fax_number": "305-273-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7765 SW 87TH AVE",
            "address_2": "SUITE 210",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331732596",
            "telephone_number": "305-273-5353",
            "fax_number": "305-273-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANENBAUM",
        "first_name": "MYRON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "0041105",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "41105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0489972-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.