NPIMap

Organization Active NPI

North Broward Hospital District

Doing business as Broward Health North - Rehab

  • Rehabilitation Hospital Unit
  • Pompano Beach, FL
National Provider Identifier
1295763241
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
4020 Issued in FL
Legal business name
NORTH BROWARD HOSPITAL DISTRICT
Doing business as
Broward Health North - Rehab
Practice address
201 E Sample Rd
Pompano Beach, FL 33064-3502
Phone
(954) 941-8300
Fax
(954) 847-4245
NPI assigned
Jun 29, 2006
Last updated
May 10, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Authorized official

Name
Alisa Bert
Title
Interim Cfo
Phone
(954) 473-7483

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 4020 FL Primary

Addresses

Primary practice location

201 E Sample Rd
Pompano Beach, FL 33064-3502

Mailing address

1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750

Other names 1

  • Broward Health North - Rehab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040405001860 FL Part B Supplier - Clinic/Group Practice 3577472422 Receives reassigned benefits from 251 practitioners
This NPI is an additional NPI on the enrollment
O20080530000511 FL Part A Provider - Hospital 3577472422 Practice locations: Deerfield Beach, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295763241. Details of each certification follow.

Hospital certification: CCN 10T086

Legal name
NORTH BROWARD HOSPITAL DISTRICT
Doing business as
BROWARD HEALTH NORTH- REHAB UNIT
Organization structure
GovernmentNon-profit
Enrollment address
201 E Sample Rd
Deerfield Beach, FL 33064-3502
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 24

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Broward Health North-Inpatient Rehabilitation UnitCCN 10T086 · All quality measures
Ownership
Government
Certified
Jul 1, 2024

National Provider Directory

National Provider Directory
Tax ID family
Lauderdale Medical Grou140 organizations share this tax ID, including this one
Part of
Lauderdale Medical Grou

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Networks

  • HealthSun Health Plans Network

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stuart M Glassberg Individual W-2 Managing Employee Jun 25, 2010
Nancy Gregoire Individual Corporate OfficerBoard of Commissioners Member Dec 1, 2017
Stacy Angier Individual Corporate OfficerBoard of Commissioners Member Oct 19, 2018
North Broward Hospital District Organization, Fort Lauderdale, FL Non-profit Operational/Managerial Control May 13, 2008
Matthew K Garner Individual Corporate OfficerCeo Aug 29, 2022
Corporate DirectorCeo Aug 29, 2022
Operational/Managerial ControlCeo Aug 29, 2022
Paul C. Tanner Individual Corporate OfficerBoard Commissioner Member May 20, 2022
Corporate DirectorBoard Commissioner Member May 20, 2022
Operational/Managerial ControlBoard Commissioner Member May 20, 2022
Ray Berry Individual Corporate OfficerBoard of Commissioners Member May 11, 2018
Levi Williams Individual Corporate OfficerBoard Member Apr 2, 2021
Shane Strum Individual Corporate OfficerCeo Mar 29, 2021
Corporate DirectorCeo Mar 29, 2021
Operational/Managerial ControlCeo Mar 29, 2021
Christopher Pernicano Individual Corporate OfficerBoard Commissioner Member Apr 2, 2021
Corporate DirectorBoard Commissioner Member Apr 2, 2021
Operational/Managerial ControlBoard Commissioner Member Apr 2, 2021
Jonathan Hage Individual Corporate OfficerBoard Commissioner Member Apr 2, 2021
Corporate DirectorBoard Commissioner Member Apr 2, 2021
Operational/Managerial ControlBoard Commissioner Member Apr 2, 2021
Alisa Bert Individual Corporate OfficerCfo Mar 3, 2023
Corporate DirectorCfo Mar 3, 2023
Operational/Managerial ControlCfo Mar 3, 2023

Owners & managing parties with NPI records 24

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 24

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Broward Health NorthDeerfield Beach, FL, CCN 100086 Hospital Operational/Managerial Control May 14, 2008
Broward Health Imperial PointFort Lauderdale, FL, CCN 100200 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 1, 1984
Jan 1, 1984
Broward Health Medical Center-Psych UnitFort Lauderdale, FL, CCN 10S039 Hospital Operational/Managerial Control Jul 1, 2007
Broward Health Coral SpringsCoral Springs, FL, CCN 100276 Hospital Operational/Managerial Control (100%) Mar 17, 1987
Broward Health Imperial Point-Psych UnitFort Lauderdale, FL, CCN 10S200 Hospital Operational/Managerial Control (100%) Jul 1, 1984
Pompano Adult Primary CarePompano Beach, FL, CCN 101840 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 1993
Oct 1, 1993
Specialty Care CenterFort Lauderdale, FL, CCN 101841 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 1993
Jul 1, 1993
Margate Health CenterMargate, FL, CCN 681892 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 1993
Oct 1, 1993

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

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.

Affiliated clinicians 8

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1295763241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E SAMPLE RD",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330643502",
            "telephone_number": "954-941-8300",
            "fax_number": "954-847-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "enumeration_date": "2006-06-29",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "BERT",
        "authorized_official_first_name": "ALISA",
        "authorized_official_title_or_position": "INTERIM CFO",
        "authorized_official_telephone_number": "954-473-7483"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "FL",
            "license": "4020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broward Health North - Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Broward Health North - Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.