Individual provider Active NPI

Mason P Hershorin, MSN ARNP

  • Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1649201401
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP2516442 Issued in FL
Practice address
311 SW 99TH Terrace
Pembroke Pines, FL 33025-1065
Phone
(954) 444-7661
Fax
(954) 430-3261
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP2516442 FL Primary

Addresses

Primary practice location

311 SW 99TH Terrace
Pembroke Pines, FL 33025-1065

Mailing address

311 SW 99TH Terrace
Pembroke Pines, FL 33025-1065
Phone (954) 444-7661

Other identifiers 2

IdentifierTypeStateIssuer
302350800MedicaidFL
CK3521OtherTRICARE WPS

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060202000079 FL Practitioner - Nurse Practitioner 1052325743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mason Hershorin MSN Arnp Inc.Group PAC ID 4789685777, 3 clinicians

Practice addresses (Care Compare)

2728 SE 16TH PL
Cape Coral, FL 33904-3209
Phone (239) 573-7598

Hospital & facility affiliations

  • Preferred Care Home Health Services Home health agency, Fort Myers, FL, CCN 109423
  • Amedisys Home Health Home health agency, Port Charlotte, FL, CCN 108270
  • All Broward Home Health Services Inc Home health agency, Davie, FL, CCN 109642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP2516442FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mason Hershorin MSN Arnp Inc. Current Accepting new patients
Mason Hershorin MSN Arnp Inc. Nurse Practitioner CurrentSince Mar 17, 2002 Accepting new patients
Integrated-1 Corp Past Accepting new patients

Locations

2728 SE 16th Pl
Cape Coral, FL 33904
Phone (239) 573-7598

Organizations & group practices 3

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 3

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1649201401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 SW 99TH TERRACE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330251065",
            "telephone_number": "954-444-7661",
            "fax_number": "954-430-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 SW 99TH TERRACE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330251065",
            "telephone_number": "954-444-7661",
            "fax_number": "954-430-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSHORIN",
        "first_name": "MASON",
        "middle_name": "P",
        "credential": "MSN ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2516442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "302350800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WPS",
            "identifier": "CK3521",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.