Individual provider Active NPI

Michael A Flicker, DO

  • Family Medicine Physician
  • Plantation, FL
National Provider Identifier
1265419709
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0S5264 Issued in FL
Practice address
10063 Cleary Blvd
Plantation, FL 33324-1063
Phone
(954) 835-0005
Fax
(954) 476-7634
NPI assigned
Dec 27, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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
Family Medicine Physician 207Q00000X 0S5264 FL Primary

Addresses

Primary practice location

10063 Cleary Blvd
Plantation, FL 33324-1063

Mailing address

10063 Cleary Blvd
Plantation, FL 33324-1063
Phone (954) 835-0005

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
I20060105000336 FL Practitioner - General PracticePractitioner - Family Practice 1355364381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Nova Southeastern College of Osteo Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

817 S University Dr
Suite 120
Plantation, FL 33324-3318
Phone (954) 835-0005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0S5264FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael a Flicker DO PA Family Medicine CurrentSince Oct 1, 2006 Accepting new patients
Coral Ridge Surgical Center, LLC PastSince Mar 30, 2012 Accepting new patients
Broward Anesthesia Partners LLC PastSince Apr 11, 2012 Accepting new patients

Locations

10063 Cleary Blvd
Plantation, FL 33324
Phone (954) 452-0010

817 S University Dr
Ste 120
Plantation, FL 33324
Phone (954) 474-9777

9633 W Broward Blvd
Ste 6
Plantation, FL 33324
Phone (954) 472-5933

Organizations & group practices 5

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265419709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10063 CLEARY BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241063",
            "telephone_number": "954-835-0005",
            "fax_number": "954-476-7634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10063 CLEARY BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241063",
            "telephone_number": "954-835-0005",
            "fax_number": "954-476-7634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLICKER",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "0S5264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.