Individual provider Active NPI

Fawwaz Jaffer Mohiuddin, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Plantation, FL
National Provider Identifier
1447416003
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
ME108788 Issued in FL
Practice address
8285 W Sunrise Blvd
Plantation, FL 33322-5403
Phone
(954) 730-5030
Fax
(954) 289-6502
NPI assigned
Aug 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 125-049640 IL
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X ME108788 FL Primary

Addresses

Primary practice location

8285 W Sunrise Blvd
Plantation, FL 33322-5403

Mailing address

PO Box 978766
Dallas, TX 75397-8766
Phone (954) 730-5030

Other practice location 1

1971 SW 172nd Ave # 3128
Miramar, FL 33029-5592
Phone (954) 730-5030

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
I20130111000196 FL Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 4385897842 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortho Florida LLCGroup PAC ID 3274616453, 121 clinicians

Practice addresses (Care Compare)

1601 Clint Moore Rd
Suite 125
Boca Raton, FL 33487-5714
Phone (561) 939-0800

1901 SW 172 Ave
Miramar, FL 33029-5592
Phone (954) 538-5000

1971 SW 172ND Ave
Suite 3128
Miramar, FL 33029-5592
Phone (954) 730-5030

5000 W Oakland Park Blvd
Lauderdale Lakes, FL 33313-1503
Phone (954) 735-6000

660 Glades Rd
Suite 360
Boca Raton, FL 33431-6469
Phone (561) 391-5515

8285 W Sunrise Blvd
Plantation, FL 33322-5403
Phone (954) 730-5030

Hospital & facility affiliations

  • Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285
  • North Shore Medical Center Hospital, Miami, FL, CCN 100029

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-049640ILMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tenet Florida Physician Services, LLC CurrentSince Jul 15, 2013 Accepting new patients
Ortho Florida, LLC Orthopaedic Surgery CurrentSince Mar 29, 2021 Accepting new patients
Tenet Florida Physician Services LLC CurrentSince Jul 15, 2013 Accepting new patients
Ortho Florida, LLC Orthopaedic Surgery CurrentSince Mar 29, 2021 Accepting new patients

Locations

1601 Clint Moore Rd
Ste 125
Boca Raton, FL 33487
Phone (561) 395-5733

660 Glades Rd
Ste 460
Boca Raton, FL 33431
Phone (561) 300-1792

2307 W Broward Blvd
Ste 200
Ft Lauderdale, FL 33312
Phone (954) 792-1010

3001 NW 49th Ave
Ste 301
Lauderdale Lakes, FL 33313
Phone (954) 497-1898

3001 NW 49th Ave
Ste 104
Lauderdale Lakes, FL 33313
Phone (954) 735-6333

1971 SW 172nd Ave
Ste 3128
Miramar, FL 33029
Phone (954) 730-5030

12596 Pines Blvd
Pembroke Pines, FL 33027
Phone (954) 437-4000

8285 W Sunrise Blvd
Plantation, FL 33322
Phone (954) 730-5030

1411 N Flagler Dr
Ste 8000
West Palm Beach, FL 33401
Phone (561) 650-6231

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.

Hospital & facility affiliations 3

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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1447416003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 978766",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753978766",
            "telephone_number": "954-730-5030",
            "fax_number": "954-289-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8285 W SUNRISE BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333225403",
            "telephone_number": "954-730-5030",
            "fax_number": "954-289-6502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1971 SW 172nd Ave # 3128",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330295592",
            "country_code": "US",
            "telephone_number": "954-730-5030",
            "fax_number": "954-289-6502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHIUDDIN",
        "first_name": "FAWWAZ",
        "middle_name": "JAFFER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "125-049640",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME108788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.