Individual provider Active NPI

Adam J. Oppenheimer, MD

  • Plastic and Reconstructive Surgery Physician
  • Orlando, FL
National Provider Identifier
1487786141
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
ME117130 Issued in FL
Practice address
3872 Oakwater Cir
Orlando, FL 32806-6263
Phone
(407) 377-7714
Fax
(407) 377-7714
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 60264393 WA
Plastic and Reconstructive Surgery Physician 2086S0122X ME117130 FL Primary

Addresses

Primary practice location

3872 Oakwater Cir
Orlando, FL 32806-6263

Mailing address

3872 Oakwater Cir
Orlando, FL 32806-6263
Phone (407) 377-7714

Other practice location 1

707 W Eau Gallie Blvd
Melbourne, FL 32935-5958
Phone (321) 727-3223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60264393WAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bermax II LLC Plastic Surgery CurrentSince Aug 15, 2013 Accepting new patients

Locations

707 W Eau Gallie Blvd
Melbourne, FL 32935
Phone (321) 610-8983

3 Suntree Pl
Melbourne, FL 32940
Phone (321) 610-8983

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1487786141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3872 OAKWATER CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066263",
            "telephone_number": "407-377-7714",
            "fax_number": "407-377-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3872 OAKWATER CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066263",
            "telephone_number": "407-377-7714",
            "fax_number": "407-377-7714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 W Eau Gallie Blvd",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329355958",
            "country_code": "US",
            "telephone_number": "321-727-3223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OPPENHEIMER",
        "first_name": "ADAM",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WA",
            "license": "60264393",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME117130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.