Michael Fish, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY3726 Issued in FL

Practice address

10200 W State Road 84 Ste 105
Davie, FL 33324-4218

Phone

(954) 370-7692

Fax

(954) 370-2383

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael Fish PHD PA

  • Psychologist
  • Davie, FL
  • NPI 1376723478
  Medicare reassignment NPD Authorized official
• Frank B. Roselione PH.D. P.a.

  • Clinical Psychologist
  • Plantation, FL
  • NPI 1447502091
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1548358294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4581 WESTON RD STE 374",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313141",
            "telephone_number": "954-370-7692",
            "fax_number": "954-370-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 W STATE ROAD 84 STE 105",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333244218",
            "telephone_number": "954-370-7692",
            "fax_number": "954-370-2383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10200 W State Road 84 Ste 105",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333244218",
            "country_code": "US",
            "telephone_number": "954-370-7692",
            "fax_number": "954-370-2383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISH",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY3726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "056610",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "73683",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidy Firpo, PSY.D.
• Maryan Firpo
• First Health Systems
• First Step Solutions of South Florida Inc.
• Barbara J. Fish, CFA
• Dana Fisher
• Helene Rosman Fisher, SLP.D., CCC
• Lindsay Caitlin Fishman, OTR/L
• Martha Ellen Fittro, MS, BCBA
• Cynthia Mary Fitz Andrews Williams

• Psychologist in Davie, FL
• Providers in Davie, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.