Take Shape Surgery Center LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

FL1224 Issued in FL

Legal business name

TAKE SHAPE SURGERY CENTER LLC

Practice address

4161 NW 5TH St
Suite 100
Plantation, FL 33317

Phone

(954) 585-3800

Fax

(954) 585-6100

NPI assigned

May 10, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Russell Frank Sassani, MDNPI 1194788026

Title

President Ceo

Phone

(954) 585-3800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Take Shape Surgery Center LLCCCN 10C0001452

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Russell Frank Sassani, MD

  • Plastic Surgery Physician
  • Plantation, FL
  • NPI 1194788026
  Authorized official Same address or phone

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497704985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4161 NW 5TH ST",
            "address_2": "SUITE 100",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "33317",
            "telephone_number": "954-585-3800",
            "fax_number": "954-585-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 NW 5TH ST",
            "address_2": "SUITE 100",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "33317",
            "telephone_number": "954-585-3800",
            "fax_number": "954-585-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAKE SHAPE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SASSANI",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "954-585-3800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "FL1224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jolmar Taborda Porfidio
• Jason Tache, D.O.
• Vivienne Veronica Tai, M.D.
• Tailwind Care Provider Group, P.a.
• Take Shape Plastic Surgery PA
• Abanoub Nagy Zaky Takla, M.B.B.CH
• Javier Talamo II, D.O.
• Idalia Talavera-Aviles, M.D.
• Frank B. Talerico, ED.D.
• Hali Talkington, LCSW

• Plastic Surgery Physician in Plantation, FL
• Providers in Plantation, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.