Individual provider Active NPI

Jean Claude Dubois, MD

  • General Practice Physician
  • Pompano Beach, FL
National Provider Identifier
1386789931
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME0053632 Issued in FL
Practice address
601 E Sample Road
Suite #110
Pompano Beach, FL 38064
Phone
(954) 783-5151
Fax
(954) 783-0219
NPI assigned
Feb 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME0053632 FL Primary

Addresses

Primary practice location

601 E Sample Road
Suite #110
Pompano Beach, FL 38064

Mailing address

601 E Sample Road
Suite #110
Pompano Beach, FL 38064
Phone (954) 783-5151

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120716000445 FL Practitioner - General PracticePractitioner - Psychiatry 6103080296

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PCC Medical Holdings LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386789931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E SAMPLE ROAD",
            "address_2": "SUITE #110",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "38064",
            "telephone_number": "954-783-5151",
            "fax_number": "954-783-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E SAMPLE ROAD",
            "address_2": "SUITE #110",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "38064",
            "telephone_number": "954-783-5151",
            "fax_number": "954-783-0219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "JEAN CLAUDE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME0053632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.