Organization Active NPI

Scott D Tannenbaum MD PA

  • Physical Medicine & Rehabilitation Physician
  • Sunrise, FL
National Provider Identifier
1528257458
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME57381 Issued in FL
Legal business name
SCOTT D TANNENBAUM MD PA
Practice address
4399 N Nob Hill Rd
Sunrise, FL 33351-5813
Phone
(954) 746-1338
Fax
(954) 746-1331
NPI assigned
Oct 16, 2007
Last updated
Oct 16, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Authorized official

Name
Dr. Scott D Tannenbaum, MDNPI 1295748994
Title
President
Phone
(954) 746-1338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME57381 FL Primary

Addresses

Primary practice location

4399 N Nob Hill Rd
Sunrise, FL 33351-5813

Mailing address

PO Box 267515
Weston, FL 33326-7515
Phone (954) 746-1338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031120000469 FL Part B Supplier - Clinic/Group Practice 9436053667 Receives reassigned benefits from 4 practitioners
Practice locations: Sunrise, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2002773Scott Tannenbaum MD PA4399 Nob Hill Rd, Sunrise, FL 33351Certificate of waiverJan 25, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1528257458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 267515",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333267515",
            "telephone_number": "954-746-1338",
            "fax_number": "954-746-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4399 N NOB HILL RD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333515813",
            "telephone_number": "954-746-1338",
            "fax_number": "954-746-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT D TANNENBAUM MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "TANNENBAUM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-746-1338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME57381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.