Individual provider Active NPI

Peter Leon Babinski, MD PHD

  • Dermatology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1316021124
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
36538 Issued in FL
Practice address
800 East Broward Blvd
Suite 103
Fort Lauderdale, FL 33301-2020
Phone
(954) 463-5406
Fax
(954) 522-2456
NPI assigned
Oct 25, 2006
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
Dermatology Physician 207N00000X 36538 FL Primary

Addresses

Primary practice location

800 East Broward Blvd
Suite 103
Fort Lauderdale, FL 33301-2020

Mailing address

800 East Broward Blvd
Suite 103
Fort Lauderdale, FL 33301-2020
Phone (954) 463-5406

Other identifiers 1

IdentifierTypeStateIssuer
379671000MedicaidFL

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
I20130328000369 FL Practitioner - Dermatology 2163667809 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36538FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galt Dermatology & Concierge Medicine PA CurrentSince Nov 12, 2012 Accepting new patients

Locations

800 E Broward Blvd
Ste 103
Ft Lauderdale, FL 33301
Phone (954) 463-5406

Organizations & group practices 1

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316021124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 EAST BROWARD BLVD",
            "address_2": "SUITE 103",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012020",
            "telephone_number": "954-463-5406",
            "fax_number": "954-522-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 EAST BROWARD BLVD",
            "address_2": "SUITE 103",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012020",
            "telephone_number": "954-463-5406",
            "fax_number": "954-522-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABINSKI",
        "first_name": "PETER",
        "middle_name": "LEON",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "36538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379671000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.