Active NPI
Mederline Paul
- Family Nurse Practitioner
- Fort Lauderdale, FL
National Provider Identifier
1609598036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN11009217
- Practice address
- 200 NW 7TH Ave
Fort Lauderdale, FL 33311-9026 - Phone
- (954) 759-6600
- Fax
- (954) 759-6665
- NPI assigned
- Sep 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11009217 | FL | Primary |
Addresses
Primary practice location
200 NW 7TH Ave
Fort Lauderdale, FL 33311-9026
Mailing address
1700 NW 49TH St
Fort Lauderdale, FL 33309-3763
Phone (754) 268-3850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11009217 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Salem Womens Clinic, Inc | Past | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703030400000",
"number": "1609598036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 NW 49TH ST",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333093763",
"telephone_number": "754-268-3850",
"fax_number": "954-759-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 NW 7TH AVE",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333119026",
"telephone_number": "954-759-6600",
"fax_number": "954-759-6665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAUL",
"first_name": "MEDERLINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-13",
"last_updated": "2023-12-20",
"certification_date": "2023-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11009217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.