Barry C Pevner MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME50444 Issued in FL

Legal business name

BARRY C PEVNER MD PA

Practice address

601 N Flamingo Rd
Suite 303
Pembroke Pines, FL 33028-1010

Phone

(954) 557-5407

Fax

(954) 436-8024

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Barry C Pevner, MDNPI 1184700940

Title

President

Phone

(954) 347-1360

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Barry C Pevner, MD

  • Internal Medicine Physician
  • Pembroke Pines, FL
  • NPI 1184700940
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1598875486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N FLAMINGO RD",
            "address_2": "SUITE 303",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281010",
            "telephone_number": "954-347-1360",
            "fax_number": "954-436-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N FLAMINGO RD",
            "address_2": "SUITE 303",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281010",
            "telephone_number": "954-557-5407",
            "fax_number": "954-436-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY C PEVNER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "PEVNER",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-347-1360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME50444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063488300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "b@direct.care360.com",
            "affiliation": "N",
            "address_1": "601 N Flamingo Rd",
            "address_2": "Suite 303",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330281010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patricia Barrero Wong
• Katherine Barrero
• Carol Barriere
• Michael Barron, ARNP
• George L Barros, MD
• Antionise Toussaint Barthelemy, APRN
• Faitzline Barthelemy
• Patrick Barthelemy
• Alice Bartlett, L.M.H.C.
• Sarah Irene Bartlett, M.S., BCBA

• Internal Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.