Daniel S Mirtenbaum, EDM, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9965 Issued in FL

Practice address

1848 SE 1St Ave
Fort Lauderdale, FL 33316-2875

Phone

(954) 885-9500

NPI assigned

Sep 18, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Institute for Family Therapy, Inc.Group PAC ID 8123284759, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Institute for Family Therapy Inc

  • Clinical Social Worker
  • Miami Lakes, FL
  • NPI 1407837743
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649799073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1848 SE 1ST AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1848 SE 1ST AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162875",
            "telephone_number": "954-885-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRTENBAUM",
        "first_name": "DANIEL",
        "middle_name": "S",
        "credential": "EDM, PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLDOH",
            "identifier": "PY9965",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Miret
• Carol L Mirones
• Renee Vollario Mirowitz
• Cesar Orlando Mirrieles Miranda, SA-C
• Rachel Mirsky, LMHC
• Marjan Mirzabeigi, MD
• David B Mishkin, D.O.
• Laszlo Miskolczi, M.D.
• Mislyn Place of Hope Inc
• Mitchell S Seavey MD PA

• Clinical Psychologist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.

Verify at the official NPI Registry.