Individual provider Active NPI

David Harrison, M.D.

  • Pediatrics Physician
  • Coconut Creek, FL
National Provider Identifier
1487628574
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME47299 Issued in FL
Practice address
4570 Lyons Rd
Suite 110
Coconut Creek, FL 33073-3481
Phone
(954) 971-3210
Fax
(954) 971-3427
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME47299 FL Primary

Addresses

Primary practice location

4570 Lyons Rd
Suite 110
Coconut Creek, FL 33073-3481

Mailing address

900 S Pine Island Rd
Suite 800
Plantation, FL 33324-3920
Phone (954) 971-3210

Other identifiers 1

IdentifierTypeStateIssuer
271859600MedicaidFL

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
I20240521004569 FL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0042652109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME47299FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics Past Accepting new patients
Saltzman, Tanis, Pittel, Levin and Jacobson Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dharrison@pa.trimed.direct-ci.com

Organizations & group practices 2

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1487628574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD",
            "address_2": "SUITE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243920",
            "telephone_number": "954-971-3210",
            "fax_number": "954-971-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 LYONS RD",
            "address_2": "SUITE 110",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733481",
            "telephone_number": "954-971-3210",
            "fax_number": "954-971-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME47299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271859600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

Verify at the official NPI Registry.