Individual provider Active NPI

Boaz Shmuel Rosenblat, M.D.

  • Emergency Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1508893678
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME84594 Issued in FL
Practice address
7800 Sheridan St
Pembroke Pines, FL 33024-2536
Phone
(954) 962-9650
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME84594 FL Primary

Addresses

Primary practice location

7800 Sheridan St
Pembroke Pines, FL 33024-2536

Mailing address

14050 NW 14TH St
Suite 190
Sunrise, FL 33323-2865
Phone (800) 424-3672

Other identifiers 2

IdentifierTypeStateIssuer
13496OtherFLBLUE SHIELD
264130500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brosenblat12309@mhsdirect.net

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
I20040503001217 FL Practitioner - Emergency Medicine 1759379316 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME84594FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inphynet South Broward LLC Emergency Medicine CurrentSince Jan 1, 2005 Accepting new patients

Locations

3600 Washington St
Hollywood, FL 33021
Phone (954) 265-4461

1901 SW 172nd Ave
Miramar, FL 33029
Phone (954) 276-5401

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

7800 Sheridan St
Pembroke Pines, FL 33024
Phone (954) 962-9650

703 N Flamingo Rd
Pembroke Pnes, FL 33028
Phone (954) 436-5000

Interoperability endpoints

  • Direct secure messaging: brosenblat12309@mhsdirect.net

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1508893678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14050 NW 14TH ST",
            "address_2": "SUITE 190",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232865",
            "telephone_number": "800-424-3672",
            "fax_number": "954-377-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 SHERIDAN ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330242536",
            "telephone_number": "954-962-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBLAT",
        "first_name": "BOAZ",
        "middle_name": "SHMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME84594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "13496",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264130500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brosenblat12309@mhsdirect.net",
            "affiliation": "N",
            "address_1": "7800 Sheridan St",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330242536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.