Individual provider Active NPI

Charles Michael Fischman, M.D.

  • Internal Medicine Physician
  • Vero Beach, FL
National Provider Identifier
1255314365
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME25700 Issued in FL
Practice address
1715 37TH PL FL 2
Vero Beach, FL 32960-4508
Phone
(772) 794-2222
Fax
(772) 794-0045
NPI assigned
Nov 22, 2005
Last updated
Jun 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME25700 FL Primary
Allergy & Immunology (Internal Medicine) Physician 207RA0201X ME25700 FL

Addresses

Primary practice location

1715 37TH PL FL 2
Vero Beach, FL 32960-4508

Mailing address

PO Box 38
Vero Beach, FL 32961-0038
Phone (772) 539-1775

Other identifiers 1

IdentifierTypeStateIssuer
065438800MedicaidFL

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
I20100215000373 FL Practitioner - Internal MedicinePractitioner - Allergy/ImmunologyPractitioner - Pulmonary Disease 3476520057 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Primary Care CurrentSince May 1, 2020 Accepting new patients
Steward Medical Group, Inc. Internal Medicine CurrentSince May 31, 2018 Accepting new patients
Health Associates of Tampa Bay PA Internal Medicine CurrentSince Apr 1, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince May 31, 2018 Accepting new patients

Locations

8000 Ron Beatty Blvd
Ste A-3
Sebastian, FL 32976
Phone (772) 664-1388

508 S Habana Ave
Ste 300
Tampa, FL 33609
Phone (813) 877-6770

1600 36th St
Ste C
Vero Beach, FL 32960
Phone (772) 217-4422

1715 37th Pl
Fl 2
Vero Beach, FL 32960
Phone (772) 567-4336

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HECFAD

Organizations & group practices 4

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1255314365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329610038",
            "telephone_number": "772-539-1775",
            "fax_number": "772-569-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 37TH PL FL 2",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604508",
            "telephone_number": "772-794-2222",
            "fax_number": "772-794-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHMAN",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME25700",
            "primary": true
        },
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "FL",
            "license": "ME25700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065438800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.