Organization Active NPI

James D Stern MD PA

  • Specialist
  • Fort Lauderdale, FL
National Provider Identifier
1720487218
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME57379 Issued in FL
Legal business name
JAMES D STERN MD PA
Practice address
2699 Stirling Rd Ste B101
Ft Lauderdale, FL 33312-6546
Phone
(954) 989-5001
Fax
(954) 653-1472
NPI assigned
Aug 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Authorized official

Name
Mrs. Jody Komroff
Title
Office Manager
Phone
(954) 240-3313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME57379 FL Primary

Addresses

Primary practice location

2699 Stirling Rd Ste B101
Ft Lauderdale, FL 33312-6546

Mailing address

1483 Commodore Way
Hollywood, FL 33019-5062
Phone (954) 234-3899

Other identifiers 1

IdentifierTypeStateIssuer
378408800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141014002052 FL Part B Supplier - Clinic/Group Practice 2264653385 Receives reassigned benefits from 1 practitioner
Practice locations: Aventura, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1720487218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1483 COMMODORE WAY",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330195062",
            "telephone_number": "954-234-3899",
            "fax_number": "954-653-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2699 STIRLING RD STE B101",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333126546",
            "telephone_number": "954-989-5001",
            "fax_number": "954-653-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES D STERN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-20",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "KOMROFF",
        "authorized_official_first_name": "JODY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-240-3313",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME57379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378408800",
            "state": "FL"
        }
    ],
    "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 Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.