Individual provider Active NPI

Edward I Winokur, MD

  • Internal Medicine Physician
  • Lighthouse Point, FL
National Provider Identifier
1366405649
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME120041 Issued in FL
Practice address
3896 N Federal Hwy
Lighthouse Point, FL 33064-6612
Phone
(954) 933-9600
Fax
(954) 781-9828
NPI assigned
Apr 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 030908 CT
Internal Medicine Physician 207R00000X ME120041 FL Primary
Pulmonary Disease Physician 207RP1001X 030908 CT

Addresses

Primary practice location

3896 N Federal Hwy
Lighthouse Point, FL 33064-6612

Mailing address

1608 SE 3Rd Ave
Third Floor Pbo
Fort Lauderdale, FL 33316-2564
Phone (954) 933-9600

Other identifiers 2

IdentifierTypeStateIssuer
001309089MedicaidCT
010030908CT03OtherANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME120041FLMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1366405649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 SE 3RD AVE",
            "address_2": "THIRD FLOOR PBO",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162564",
            "telephone_number": "954-933-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3896 N FEDERAL HWY",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330646612",
            "telephone_number": "954-933-9600",
            "fax_number": "954-781-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINOKUR",
        "first_name": "EDWARD",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "030908",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME120041",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "030908",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001309089",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "010030908CT03",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lighthouse Point, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.