Individual provider Active NPI

Lev H Sudakov, DC

  • Chiropractor
  • Hallandale Beach, FL
National Provider Identifier
1376540468
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8450 Issued in FL
Practice address
1801 S Ocean Dr
Suite E
Hallandale Beach, FL 33009-4945
Phone
(954) 391-7864
Fax
(954) 391-8468
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH8450 FL Primary
Chiropractor 111N00000X 010232 NY

Addresses

Primary practice location

1801 S Ocean Dr
Suite E
Hallandale Beach, FL 33009-4945

Mailing address

1801 S Ocean Dr
Suite E
Hallandale Beach, FL 33009-4945
Phone (954) 391-7864

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050426000433 FL Practitioner - Chiropractic 6800835299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1801 S Ocean Dr
E
Hallandale Beach, FL 33009-4931
Phone (347) 742-5125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lev Sudakov DC PA Chiropractor CurrentSince Jun 16, 2008 Accepting new patients
Natalia Sudakov, M.D., P.a. PastSince Jun 16, 2008 Accepting new patients

Locations

1801 S Ocean Dr
Ste E
Hallandale Beach, FL 33009
Phone (347) 742-5125

3800 S Ocean Dr
Ste 230
Hollywood, FL 33019
Phone (773) 512-1161

Organizations & group practices 2

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1376540468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 S OCEAN DR",
            "address_2": "SUITE E",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094945",
            "telephone_number": "954-391-7864",
            "fax_number": "954-391-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S OCEAN DR",
            "address_2": "SUITE E",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094945",
            "telephone_number": "954-391-7864",
            "fax_number": "954-391-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDAKOV",
        "first_name": "LEV",
        "middle_name": "H",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8450",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "010232",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.