Organization Active NPI

Leslie Shawn D.O. P.a.

  • Adult Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1295024636
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
LESLIE SHAWN D.O. P.A.
Practice address
400 N Hiatus Rd
Suite 201
Pembroke Pines, FL 33026-5214
Phone
(954) 442-3434
Fax
(954) 441-4425
NPI assigned
Apr 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Authorized official

Name
Leslie Gordon Shawn, D.O.NPI 1922057009
Title
Physician
Phone
(954) 442-3434

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
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

400 N Hiatus Rd
Suite 201
Pembroke Pines, FL 33026-5214

Mailing address

400 N Hiatus Rd
Suite 201
Pembroke Pines, FL 33026-5214
Phone (954) 442-3434

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110722000555 FL Part B Supplier - Clinic/Group Practice 3274701925 Receives reassigned benefits from 1 practitioner
Practice locations: Pembroke Pines, FL

National Provider Directory

National Provider Directory

Locations

500 N Hiatus Rd
Ste 203
Pembroke Pines, FL 33026
Phone (954) 442-3434

400 N Hiatus Rd
Ste 201
Pembroke Pines, FL 33026
Phone (954) 442-3434

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1295024636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N HIATUS RD",
            "address_2": "SUITE 201",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265214",
            "telephone_number": "954-442-3434",
            "fax_number": "954-441-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N HIATUS RD",
            "address_2": "SUITE 201",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265214",
            "telephone_number": "954-442-3434",
            "fax_number": "954-441-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESLIE SHAWN D.O. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-06",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "SHAWN",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "954-442-3434",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.