Individual provider Active NPI

David Jerard Pincus, M.D.

  • Plastic Surgery Physician
  • Boca Raton, FL
National Provider Identifier
1245463058
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
ME153259 Issued in FL
Practice address
875 Meadows Rd Ste 313
Boca Raton, FL 33486-2349
Phone
(631) 352-3556
Fax
(631) 352-3557
NPI assigned
Aug 27, 2009
Last updated
Mar 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X ME153259 FL Primary
Plastic Surgery Physician 208200000X 277916 NY

Addresses

Primary practice location

875 Meadows Rd Ste 313
Boca Raton, FL 33486-2349

Mailing address

50 Route 111 Ste 300
Smithtown, NY 11787-3700
Phone (561) 445-7676

Other practice location 1

50 Route 111 Ste 300
Smithtown, NY 11787-3700
Phone (631) 352-3556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME153259FLMDPlastic Surgery Physician
277916NYMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pincus Plastic Surgery, PA Plastic Surgery Current Accepting new patients
Pincus Plastic Surgery PC Plastic Surgery PastSince Mar 12, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1245463058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ROUTE 111 STE 300",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873700",
            "telephone_number": "561-445-7676",
            "fax_number": "316-352-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 MEADOWS RD STE 313",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862349",
            "telephone_number": "631-352-3556",
            "fax_number": "631-352-3557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Route 111 Ste 300",
            "address_purpose": "LOCATION",
            "city": "Smithtown",
            "state": "NY",
            "postal_code": "117873700",
            "country_code": "US",
            "telephone_number": "631-352-3556",
            "fax_number": "631-352-3557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINCUS",
        "first_name": "DAVID",
        "middle_name": "JERARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-27",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME153259",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "277916",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.