Individual provider Active NPI

Peter J. Marcus, D.C.

  • Chiropractor
  • Fort Lauderdale, FL
National Provider Identifier
1447313119
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7508 Issued in FL
Practice address
2710 E Oakland Park Blvd
Fort Lauderdale, FL 33306-1605
Phone
(954) 575-1175
Fax
(954) 566-0361
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7508 FL Primary

Addresses

Primary practice location

2710 E Oakland Park Blvd
Fort Lauderdale, FL 33306-1605

Mailing address

2710 E Oakland Park Blvd
Fort Lauderdale, FL 33306-1605
Phone (954) 575-1175

Other identifiers 1

IdentifierTypeStateIssuer
381384300MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120208000180 FL Practitioner - Chiropractic 4587821244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2710 E Oakland Park Blvd
Fort Lauderdale, FL 33306-1605
Phone (954) 566-3027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH7508FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Marcus Chiropractic Center, Inc Chiropractor CurrentSince Jan 1, 1999 Accepting new patients

Locations

2710 E Oakland Park Blvd
Ft Lauderdale, FL 33306
Phone (954) 566-3027

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1447313119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 E OAKLAND PARK BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061605",
            "telephone_number": "954-575-1175",
            "fax_number": "954-566-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 E OAKLAND PARK BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061605",
            "telephone_number": "954-575-1175",
            "fax_number": "954-566-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "PETER",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381384300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.