Active NPI
Brendan Lally
- Emergency Medicine Physician
- Fort Lauderdale, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- ME136054
- Practice address
- 1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510 - Phone
- (954) 355-5199
- NPI assigned
- May 7, 2015
- Last updated
- Jan 15, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | ME136054 | FL | Primary |
Addresses
Primary practice location
1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
Mailing address
1721 SE 17TH St Apt 451
Fort Lauderdale, FL 33316-3142
Phone (727) 686-4630
Other practice location 1
475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-1548
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Meharry Medical College School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
Phone (954) 939-5000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoenix Emergency Medicine of Broward LLC | Emergency Medicine | Current | Accepting new patients |
| Phoenix Emergency Medicine of Broward LLC | Emergency Medicine | Current | Accepting new patients |
| Phoenix Emergency Medicine of Broward LLC | Emergency Medicine | Current | Accepting new patients |
Locations
1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000
3114 Croasdaile Dr
#200
Durham, NC 27705
Phone (877) 751-1157
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Coral Springs, FL
- NPI 1871542969
-
- Emergency Medicine Physician
- Deerfield Beach, FL
- NPI 1407805591
-
- Emergency Medicine Physician
- Fort Lauderdale, FL
- NPI 1992708887
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Broward Health Medical Center
- General Acute Care Hospital
- Fort Lauderdale, FL
- NPI 1285662239
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1649658949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1721 SE 17TH ST APT 451",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333163142",
"telephone_number": "727-686-4630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 S ANDREWS AVE",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333162510",
"telephone_number": "954-355-5199"
}
],
"practiceLocations": [
{
"address_1": "475 Seaview Ave",
"address_purpose": "LOCATION",
"city": "Staten Island",
"state": "NY",
"postal_code": "103053436",
"country_code": "US",
"telephone_number": "718-226-1548",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LALLY",
"first_name": "BRENDAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-07",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME136054",
"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 Jan 15, 2019; 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.