NPIMap

Organization Active NPI

North Broward Hospital District

Doing business as Alw Adult Clinic

  • Federally Qualified Health Center (FQHC)
  • Pompano Beach, FL
National Provider Identifier
1497773055
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTH BROWARD HOSPITAL DISTRICT
Doing business as
Alw Adult Clinic
Pompano Adult Primary Care
Practice address
2011 NW 3Rd Ave
Pompano Beach, FL 33060-4800
Phone
(954) 786-5901
Fax
(954) 786-0129
NPI assigned
Jul 18, 2006
Last updated
Apr 29, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Authorized official

Name
Alisa Bert
Title
Interim Cfo
Phone
(954) 473-7483

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Infectious Disease Physician 207RI0200X

Addresses

Primary practice location

2011 NW 3Rd Ave
Pompano Beach, FL 33060-4800

Mailing address

1608 SE 3Rd Ave FL 3
Fort Lauderdale, FL 33316-2564
Phone (954) 786-5901

Other identifiers 4

IdentifierTypeStateIssuer
060075003MedicaidFL
113196312MedicaidFL
00020OtherFLBCBS FL
101840OtherFLBCBS

Other names 2

  • ALW ADULT CLINIC Doing business as
  • Pompano Adult Primary Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030417000004 FL Part A Provider - Federally Qualified Health Center (FQHC) 3577472422 Practice locations: Pompano Beach, FL
O20040405001860 FL Part B Supplier - Clinic/Group Practice 3577472422 Receives reassigned benefits from 251 practitioners
This NPI is an additional NPI on the enrollment

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497773055. Details of each certification follow.

Federally qualified health center certification: CCN 101840

Legal name
NORTH BROWARD HOSPITAL DISTRICT
Doing business as
POMPANO ADULT PRIMARY CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
Non-profit – corporation
Organization structure
GovernmentNon-profit
Enrollment address
2011 NW 3Rd Ave
Pompano Beach, FL 33060-4800

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 24

National Provider Directory

National Provider Directory
Tax ID family
Lauderdale Medical Grou140 organizations share this tax ID, including this one
Part of
Lauderdale Medical Grou

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Networks

  • HealthSun Health Plans Network

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stuart M Glassberg Individual W-2 Managing Employee Jun 25, 2010
Nancy Gregoire Individual Corporate OfficerBoard of Commissioners Member Dec 1, 2017
Stacy Angier Individual Corporate OfficerBoard of Commissioners Member Oct 19, 2018
North Broward Hospital District Organization, Fort Lauderdale, FL 5% Or Greater Direct Ownership Interest Jul 1, 1993 100%
Operational/Managerial Control Oct 1, 1993 100%
Krystle Martin Individual Corporate OfficerChief Financial Officer Dec 2, 2024
Ray Berry Individual Corporate OfficerBoard of Commissioners Member May 11, 2018
Marie Waugh Individual Corporate OfficerBoard of Commissioners Member Nov 30, 2018
Levi Williams Individual Corporate OfficerBoard Member Apr 2, 2021
Shane Strum Individual Corporate OfficerCeo Mar 29, 2021
Corporate DirectorCeo Mar 29, 2021
Operational/Managerial ControlCeo Mar 29, 2021
Christopher Pernicano Individual Corporate OfficerBoard Member Apr 2, 2021
Jonathan Hage Individual Corporate OfficerBoard Member Apr 2, 2021
Alisa Bert Individual Corporate OfficerInterim Chief Financial Officer Mar 3, 2023

Owners & managing parties with NPI records 24

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 24

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Broward Health NorthDeerfield Beach, FL, CCN 100086 Hospital Operational/Managerial Control May 14, 2008
Broward Health Imperial PointFort Lauderdale, FL, CCN 100200 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 1, 1984
Jan 1, 1984
Broward Health Medical Center-Psych UnitFort Lauderdale, FL, CCN 10S039 Hospital Operational/Managerial Control Jul 1, 2007
Broward Health Coral SpringsCoral Springs, FL, CCN 100276 Hospital Operational/Managerial Control (100%) Mar 17, 1987
Broward Health Imperial Point-Psych UnitFort Lauderdale, FL, CCN 10S200 Hospital Operational/Managerial Control (100%) Jul 1, 1984
Broward Health North- Rehab UnitDeerfield Beach, FL, CCN 10T086 Hospital Operational/Managerial Control May 13, 2008
Specialty Care CenterFort Lauderdale, FL, CCN 101841 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 1993
Jul 1, 1993
Margate Health CenterMargate, FL, CCN 681892 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 1993
Oct 1, 1993

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777420800000",
    "number": "1497773055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 SE 3RD AVE FL 3",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162564",
            "telephone_number": "954-786-5901",
            "fax_number": "954-786-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 NW 3RD AVE",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330604800",
            "telephone_number": "954-786-5901",
            "fax_number": "954-786-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "enumeration_date": "2006-07-18",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A",
        "authorized_official_last_name": "BERT",
        "authorized_official_first_name": "ALISA",
        "authorized_official_title_or_position": "INTERIM CFO",
        "authorized_official_telephone_number": "954-473-7483"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060075003",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113196312",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "00020",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "101840",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALW ADULT CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pompano Adult Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pompano Adult Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.