Individual provider Active NPI

Mark Aaron Fridman, PA-C

  • Physician Assistant
  • Weston, FL
National Provider Identifier
1326697483
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9912447 Issued in FL
Practice address
2950 Cleveland Clinic Blvd
Weston, FL 33331-3609
Phone
(954) 659-5000
NPI assigned
Sep 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9912447 FL Primary

Addresses

Primary practice location

2950 Cleveland Clinic Blvd
Weston, FL 33331-3609

Mailing address

209 Poinciana Dr
Sunny Isles Beach, FL 33160-4522
Phone (305) 542-0149

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191206000125 FL Practitioner - Physician Assistant 6901239854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

1131 N 35TH Ave
Suite 300
Hollywood, FL 33021-5403
Phone (954) 265-1616

5830 Coral Ridge Dr
Suite 140
Coral Springs, FL 33076-3388
Phone (954) 265-1616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9912447FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Florida a Nonprofit Corporation CurrentSince Nov 11, 2019 Accepting new patients
South Broward Hospital District CurrentSince Aug 1, 2023 Accepting new patients
South Broward Hospital District CurrentSince Aug 1, 2023 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

5830 Coral Ridge Dr
Ste 140
Coral Springs, FL 33076
Phone (954) 265-1616

1131 N 35th Ave
Ste 300
Hollywood, FL 33021
Phone (954) 265-1616

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

2950 Cleveland Clinic Blvd
Weston, FL 33331
Phone (954) 689-5000

Organizations & group practices 4

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": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1326697483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 POINCIANA DR",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331604522",
            "telephone_number": "305-542-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 CLEVELAND CLINIC BLVD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313609",
            "telephone_number": "954-659-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDMAN",
        "first_name": "MARK",
        "middle_name": "AARON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9912447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

Verify at the official NPI Registry.