Individual provider Active NPI

David B Mishkin, D.O.

  • Family Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1700896206
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS 8314 Issued in FL
Practice address
2021 E Commercial Blvd
Suite 301
Fort Lauderdale, FL 33308
Phone
(954) 202-7899
Fax
(954) 202-7877
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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 OS 8314 FL Primary

Addresses

Primary practice location

2021 E Commercial Blvd
Suite 301
Fort Lauderdale, FL 33308

Mailing address

2021 E Commercial Blvd
Suite 301
Fort Lauderdale, FL 33308
Phone (954) 202-7899

Other identifiers 1

IdentifierTypeStateIssuer
269939700MedicaidFL

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
I20040412000649 FL Practitioner - Internal Medicine 3577556299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1960 NE 47TH St
FL 2
Fort Lauderdale, FL 33308-7708
Phone (954) 202-7899

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS 8314FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David Mishkin D.O. P.a. Family Medicine CurrentSince Feb 10, 2003 Accepting new patients
Primary Care Medical Associates Inc Family Medicine Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Primary Care Medical Associates, Inc. Family Medicine Past Accepting new patients

Locations

1960 NE 47th St
Fl 2
Ft Lauderdale, FL 33308
Phone (954) 202-7899

2021 E Commercial Blvd
Ste 301
Ft Lauderdale, FL 33308
Phone (954) 202-7899

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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 5

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1700896206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 E COMMERCIAL BLVD",
            "address_2": "SUITE 301",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "954-202-7899",
            "fax_number": "954-202-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 E COMMERCIAL BLVD",
            "address_2": "SUITE 301",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "954-202-7899",
            "fax_number": "954-202-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHKIN",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS 8314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269939700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.