Organization Active NPI

Lower Keys Urology PLLC

  • Urology Physician
  • Key West, FL
National Provider Identifier
1285895763
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
LOWER KEYS UROLOGY PLLC
Practice address
3714 N Roosevelt Blvd
Key West, FL 33040-4533
Phone
(305) 296-0000
Fax
(305) 296-0002
NPI assigned
Jun 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Authorized official

Name
Bruce L Fariss, MDNPI 1760480842
Title
Owner
Phone
(305) 296-0000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

3714 N Roosevelt Blvd
Key West, FL 33040-4533

Mailing address

3714 N Roosevelt Blvd
Key West, FL 33040-4533
Phone (305) 296-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080812000811 FL Part B Supplier - Clinic/Group Practice 0143395004 Receives reassigned benefits from 1 practitioner
Practice locations: Key West, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1085988Lower Keys Urology3714 N Roosevelt Blvd, Key West, FL 33040Certificate of waiverNov 11, 2027

National Provider Directory

National Provider Directory

Locations

819 Peacock Plz
#903
Key West, FL 33040

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482192000000",
    "number": "1285895763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3714 N ROOSEVELT BLVD",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330404533",
            "telephone_number": "305-296-0000",
            "fax_number": "305-296-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3714 N ROOSEVELT BLVD",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330404533",
            "telephone_number": "305-296-0000",
            "fax_number": "305-296-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWER KEYS UROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2016-12-20",
        "status": "A",
        "authorized_official_last_name": "FARISS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-296-0000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Key West, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.