Individual provider Active NPI

Marcela Fundaminsky, MD

  • Family Medicine Physician
  • Aventura, FL
National Provider Identifier
1639136252
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME84818 Issued in FL
Practice address
20801 Biscayne Blvd Ste 201
Aventura, FL 33180-1422
Phone
(305) 682-2740
Fax
(054) 276-1043
NPI assigned
Apr 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME84818 FL Primary

Addresses

Primary practice location

20801 Biscayne Blvd Ste 201
Aventura, FL 33180-1422

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Other identifiers 1

IdentifierTypeStateIssuer
105891800MedicaidFL

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
I20070426000075 FL Practitioner - Family Practice 7113926106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, shared by 55 NPIs, 659 clinicians

Practice addresses (Care Compare)

20801 Biscayne Blvd
Aventura, FL 33180-1422

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-9976

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Oct 1, 2021 Accepting new patients
South Broward Hospital District Family Medicine CurrentSince Oct 1, 2022 Accepting new patients
South Broward Hospital District CurrentSince Oct 1, 2021 Accepting new patients
South Broward Hospital District Family Medicine Current Accepting new patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

20801 Biscayne Blvd
Ste 201
Aventura, FL 33180
Phone (305) 682-2740

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

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

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1639136252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20801 BISCAYNE BLVD STE 201",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801422",
            "telephone_number": "305-682-2740",
            "fax_number": "054-276-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDAMINSKY",
        "first_name": "MARCELA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME84818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105891800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.