NPIMap

Organization Active NPI

South Broward Hospital District

Doing business as Memorial House Staff Physicians

  • Specialist
  • Hollywood, FL
National Provider Identifier
1407897960
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SOUTH BROWARD HOSPITAL DISTRICT
Doing business as
Memorial House Staff Physicians
Practice address
3501 Johnson St
Hollywood, FL 33021-5421
Phone
(954) 987-2000
Fax
(954) 602-2813
NPI assigned
Jun 8, 2006
Last updated
Oct 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Authorized official

Name
Mr. Peter Powers
Title
Hospital Administrator
Phone
(954) 265-5814

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X FL Primary

Addresses

Primary practice location

3501 Johnson St
Hollywood, FL 33021-5421

Mailing address

PO Box 862233
Orlando, FL 32886-2233
Phone (954) 987-2000

Other names 1

  • Memorial House Staff Physicians Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040107000217 FL Part B Supplier - Clinic/Group Practice 8123927373 Receives reassigned benefits from 490 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pembroke Pines, FL; Miramar, FL; Hollywood, FL; Wellington, FL; Weston, FL; Aventura, FL; Boca Raton, FL; Coral Springs, FL…

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hosp Div Ortho58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1407897960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 862233",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328862233",
            "telephone_number": "954-987-2000",
            "fax_number": "954-602-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-987-2000",
            "fax_number": "954-602-2813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BROWARD HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "POWERS",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "HOSPITAL ADMINISTRATOR",
        "authorized_official_telephone_number": "954-265-5814",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial House Staff Physicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial House Staff Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.