Organization Active NPI

Westgate Medical Center, Inc

  • Internal Medicine Physician
  • Sunrise, FL
National Provider Identifier
1730435751
Registry record updated Jul 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME034447 Issued in FL
Legal business name
WESTGATE MEDICAL CENTER, INC
Practice address
15814 W State Road 84
Sunrise, FL 33326-1227
Phone
(954) 384-7200
Fax
(954) 389-9019
NPI assigned
Jul 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2012

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

Authorized official

Name
Ms. Nina Joy Pearlmutter, M.D.NPI 1205870185
Title
Owner/President
Phone
(954) 384-7200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME034447 FL Primary

Addresses

Primary practice location

15814 W State Road 84
Sunrise, FL 33326-1227

Mailing address

15814 W State Road 84
Sunrise, FL 33326-1227
Phone (954) 384-7200

Other identifiers 1

IdentifierTypeStateIssuer
160624900OtherUS DEPT OF LABOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120829000370 FL Part B Supplier - Clinic/Group Practice 8628225455 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Lauderdale, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0285858Westgate Medical Center15814 W State Road 84, Fort Lauderdale, FL 33326Certificate of waiverJul 26, 2028

National Provider Directory

National Provider Directory

Locations

15814 W State Road 84
Sunrise, FL 33326
Phone (954) 384-1747

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343347200000",
    "number": "1730435751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15814 W STATE ROAD 84",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261227",
            "telephone_number": "954-384-7200",
            "fax_number": "954-389-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15814 W STATE ROAD 84",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261227",
            "telephone_number": "954-384-7200",
            "fax_number": "954-389-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTGATE MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-27",
        "last_updated": "2012-07-27",
        "status": "A",
        "authorized_official_last_name": "PEARLMUTTER",
        "authorized_official_first_name": "NINA",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "954-384-7200",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME034447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "160624900",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.