Individual provider Active NPI

Mrinal Sen Garg, M.D.

  • Gastroenterology Physician
  • Pompano Beach, FL
National Provider Identifier
1427393065
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME135849 Issued in FL
Practice address
601 E Sample Rd Ste 105
Pompano Beach, FL 33064
Phone
(954) 943-1133
NPI assigned
Dec 9, 2012
Last updated
Sep 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X ME135849 FL Primary

Addresses

Primary practice location

601 E Sample Rd Ste 105
Pompano Beach, FL 33064

Mailing address

601 E Sample Rd Ste 105
Pompano Beach, FL 33064-4443

Other practice location 1

4515 Wiles Rd Ste 201
Coconut Creek, FL 33073-3414
Phone (954) 943-1133

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
I20181109002009 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 0840413589 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
New York Medical College, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Florida Surgical Specialists LLCGroup PAC ID 5799881660, 91 clinicians

Practice addresses (Care Compare)

4515 Wiles Rd
Suite 201
Coconut Creek, FL 33073-3414
Phone (954) 943-1133

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy39
Upper gastrointestinal (GI) endoscopy for acid reflux32

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Subhash C. Gupta, MD, PA Single Specialty CurrentSince Sep 4, 2018 Accepting new patients
South Florida Surgical Specialists LLC Single Specialty CurrentSince Jan 1, 2024 Accepting new patients

Locations

4515 Wiles Rd
Ste 201
Coconut Creek, FL 33073
Phone (954) 943-1133

601 E Sample Rd
Ste 105
Deerfield Beach, FL 33064
Phone (954) 344-2522

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1355011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1427393065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E SAMPLE RD STE 105",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330644443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E SAMPLE RD STE 105",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "33064",
            "telephone_number": "954-943-1133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4515 Wiles Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Coconut Creek",
            "state": "FL",
            "postal_code": "330733414",
            "country_code": "US",
            "telephone_number": "954-943-1133",
            "fax_number": "954-783-6845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARG",
        "first_name": "MRINAL",
        "middle_name": "SEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-09",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME135849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.