Organization Active NPI

North Broward Hospital District

Doing business as BHPG Weston Phys 113

  • Pediatric Endocrinology Physician
  • Weston, FL
National Provider Identifier
1760076343
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
Legal business name
NORTH BROWARD HOSPITAL DISTRICT
Doing business as
BHPG Weston Phys 113
BHPG Weston Physician Office 6
Practice address
2300 N Commerce Pkwy Ste 113
Weston, FL 33326-3255
Phone
(954) 217-3171
Fax
(954) 217-3176
NPI assigned
Feb 24, 2021
Last updated
Oct 17, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Mr. Alisa Bert
Title
Interim Cfo
Phone
(954) 847-4117

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0205X Primary
Pediatric Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0206X

Addresses

Primary practice location

2300 N Commerce Pkwy Ste 113
Weston, FL 33326-3255

Mailing address

1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 217-5720

Other names 2

  • BHPG WESTON PHYS 113 Doing business as
  • BHPG Weston Physician Office 6 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001860 FL Part B Supplier - Clinic/Group Practice 3577472422 Receives reassigned benefits from 251 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
NBHD Imperial Point Med

Practitioners & affiliated clinicians

Practitioners 3

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": "1614124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1760076343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-217-5720",
            "fax_number": "954-217-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N COMMERCE PKWY STE 113",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263255",
            "telephone_number": "954-217-3171",
            "fax_number": "954-217-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "enumeration_date": "2021-02-24",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "BERT",
        "authorized_official_first_name": "ALISA",
        "authorized_official_title_or_position": "INTERIM CFO",
        "authorized_official_telephone_number": "954-847-4117",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BHPG WESTON PHYS 113",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHPG Weston Physician Office 6",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHPG Weston Physician Office 6",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.