Individual provider Active NPI

Peter Mark Cohen, D.O.

  • Family Medicine Physician
  • Davie, FL
National Provider Identifier
1407934110
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS6864 Issued in FL
Practice address
3200 S University Dr
Davie, FL 33328-2018
Phone
(954) 262-4100
Fax
(954) 262-3753
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS6864 FL Primary

Addresses

Primary practice location

3200 S University Dr
Davie, FL 33328-2018

Mailing address

16507 Diamond PL
Weston, FL 33331-3103
Phone (954) 349-0995

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://login.intelichart.com/NSUHealthClinics/

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
I20100817001614 FL Practitioner - Family Practice 2062546609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nova Southeastern University IncGroup PAC ID 4486568896, 97 clinicians

Practice addresses (Care Compare)

8501 SW 124TH Ave
Suite 111a
Miami, FL 33183-4631
Phone (954) 262-4343

Merit-based Incentive Payment System (MIPS)

Final score
72.47 of 100Reported as group
Quality
62.45
Improvement activities
40
Cost
73.28

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc Current Accepting new patients
Nova Southeastern University, Inc CurrentSince Jan 28, 2015 Accepting new patients
Nova Southeastern University, Inc Family Medicine Past Accepting new patients
Nova Southeastern University, Inc Family Medicine Past Accepting new patients

Locations

3200 S University Dr
Bldg 2ND
Davie, FL 33328
Phone (954) 262-4200

3200 S University Dr
#L
Davie, FL 33328

3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250

3200 S University Dr
Fl 1
Davie, FL 33328

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

Organizations & group practices 4

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1407934110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16507 DIAMOND PL",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313103",
            "telephone_number": "954-349-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4100",
            "fax_number": "954-262-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "PETER",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS6864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://login.intelichart.com/NSUHealthClinics/",
            "affiliation": "N",
            "address_1": "3200 S University Dr",
            "city": "Davie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333282018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.