Active NPI
North Broward Hospital District
- Pediatrics Physician
- Fort Lauderdale, FL
National Provider Identifier
1770511727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- NORTH BROWARD HOSPITAL DISTRICT
- Practice address
- 2866 E Oakland Park Blvd Ste 2
Fort Lauderdale, FL 33306-1819 - Phone
- (954) 462-8323
- Fax
- (954) 463-1149
- NPI assigned
- Jun 29, 2006
- Organization subpart
- Yes
- Parent organization
- NORTH BROWARD HOSPITAL DISTRICT
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alisa Bert
- Title
- Interim Cfo
- Phone
- (954) 847-4117
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary |
Addresses
Primary practice location
2866 E Oakland Park Blvd Ste 2
Fort Lauderdale, FL 33306-1819
Mailing address
1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 462-8323
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00020 | Other | FL | BCBS |
| 253794010 | Medicaid | FL |
Other names 1
- BH Physicians Main
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Robert L Odell MD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1711929600000",
"number": "1770511727",
"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": "954-462-8323",
"fax_number": "954-463-1149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2866 E OAKLAND PARK BLVD STE 2",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333061819",
"telephone_number": "954-462-8323",
"fax_number": "954-463-1149"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH BROWARD HOSPITAL DISTRICT",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "NORTH BROWARD HOSPITAL DISTRICT",
"enumeration_date": "2006-06-29",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"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"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "00020",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "253794010",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "BH Physicians Main",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "BH Physicians Main",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fort Lauderdale, FL
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
- North Broward Hospital District
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.