Individual provider Active NPI

Stuart Paul Farber, M.D.

  • Vascular Surgery Physician
  • Hollywood, FL
National Provider Identifier
1376742114
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0040326 Issued in FL
Practice address
3990 Sheridan St Ste 210
Hollywood, FL 33021-3656
Phone
(954) 962-9311
Fax
(954) 962-5826
NPI assigned
Jul 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 0040326 FL Primary

Addresses

Primary practice location

3990 Sheridan St Ste 210
Hollywood, FL 33021-3656

Mailing address

3560 N 55TH Ave
Hollywood, FL 33021-2342
Phone (954) 962-9311

Other identifiers 1

IdentifierTypeStateIssuer
066591600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0040326FLMDVascular Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1376742114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 N 55TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330212342",
            "telephone_number": "954-962-9311",
            "fax_number": "954-962-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 SHERIDAN ST STE 210",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213656",
            "telephone_number": "954-962-9311",
            "fax_number": "954-962-5826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARBER",
        "first_name": "STUART",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "0040326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066591600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.