Organization Active NPI

Jeffrey Rothstein, D.O. P.a.

  • Primary Care Clinic/Center
  • Hollywood, FL
National Provider Identifier
1326014762
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
JEFFREY ROTHSTEIN, D.O. P.A.
Practice address
4030 Sheridan St
Suite a
Hollywood, FL 33021-3564
Phone
(954) 963-6530
Fax
(954) 963-8587
NPI assigned
Feb 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Authorized official

Name
Dr. Jeffrey Rothstein, D.O.NPI 1518933944
Title
President
Phone
(954) 963-6530

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

4030 Sheridan St
Suite a
Hollywood, FL 33021-3564

Mailing address

4030 Sheridan St
Suite a
Hollywood, FL 33021-3564
Phone (954) 963-6530

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070203000077 FL Part B Supplier - Clinic/Group Practice 3274535257 Receives reassigned benefits from 4 practitioners
Practice locations: Hollywood, FL

National Provider Directory

National Provider Directory

Locations

4030 Sheridan St
Ste A
Hollywood, FL 33021
Phone (954) 963-6530

Practitioners & affiliated clinicians

Practitioners 5

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": "1140912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1326014762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 SHERIDAN ST",
            "address_2": "SUITE A",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213564",
            "telephone_number": "954-963-6530",
            "fax_number": "954-963-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 SHERIDAN ST",
            "address_2": "SUITE A",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213564",
            "telephone_number": "954-963-6530",
            "fax_number": "954-963-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY ROTHSTEIN, D.O. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-26",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "ROTHSTEIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-963-6530",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.