Individual provider Active NPI

Laura H Neustater

  • Developmental - Behavioral Pediatrics Physician
  • Fort Lauderdale, FL
National Provider Identifier
1255344875
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
ME63867 Issued in FL
Practice address
1900 E Commercial Blvd
Suite 202
Ft Lauderdale, FL 33308-3737
Phone
(954) 351-5840
Fax
(954) 772-5739
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X ME63867 FL Primary

Addresses

Primary practice location

1900 E Commercial Blvd
Suite 202
Ft Lauderdale, FL 33308-3737

Mailing address

1900 E Commercial Blvd
Suite 202
Ft Lauderdale, FL 33308-3737
Phone (954) 351-5840

Other identifiers 1

IdentifierTypeStateIssuer
377459700MedicaidFL

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
I20230130000086 FL Practitioner - Pediatric Medicine 6002242401 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital, Inc CurrentSince Nov 1, 2022 Accepting new patients
Holy Cross Hospital Inc CurrentSince Nov 1, 2022 Accepting new patients

Locations

1900 E Commercial Blvd
Ste 202
Ft Lauderdale, FL 33308
Phone (954) 351-5840

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

Interoperability endpoints

  • Direct secure messaging: lneustater2017076@direct.trinity-health.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255344875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 E COMMERCIAL BLVD",
            "address_2": "SUITE 202",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083737",
            "telephone_number": "954-351-5840",
            "fax_number": "954-772-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E COMMERCIAL BLVD",
            "address_2": "SUITE 202",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083737",
            "telephone_number": "954-351-5840",
            "fax_number": "954-772-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUSTATER",
        "first_name": "LAURA",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "FL",
            "license": "ME63867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377459700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.