Active NPI
Broc Lane Pratt, M.D
- Family Medicine Physician
- Miami Beach, FL
National Provider Identifier
1770522849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2005-01398
- Practice address
- 300 71 Street
Suite 620
Miami Beach, FL 33141-3089 - Phone
- (305) 866-9951
- Fax
- (877) 284-8933
- NPI assigned
- Jun 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2005-01398 | NC | Primary |
| Plastic Surgery Physician | 208200000X | 0090-00308 | NC | |
| Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | 2082S0099X | 2005-01398 | NC | |
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 2005-01398 | NC |
Addresses
Primary practice location
300 71 Street
Suite 620
Miami Beach, FL 33141-3089
Mailing address
PO Box 32861
Charlotte, NC 28232-2861
Phone (704) 446-6810
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5901841 | Medicaid | NC | |
| 140KC | Other | NC | NCBCBS |
| N98005 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0090-00308 | NC | MD | Plastic Surgery Physician |
| 2005-01398 | NC | MD | Plastic and Reconstructive Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280275200000",
"number": "1770522849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 32861",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282322861",
"telephone_number": "704-446-6810",
"fax_number": "877-284-8933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 71 STREET",
"address_2": "SUITE 620",
"city": "MIAMI BEACH",
"state": "FL",
"postal_code": "331413089",
"telephone_number": "305-866-9951",
"fax_number": "877-284-8933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRATT",
"first_name": "BROC",
"middle_name": "LANE",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2010-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2005-01398",
"primary": true
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "NC",
"license": "0090-00308",
"primary": false
},
{
"code": "2082S0099X",
"taxonomy_group": "",
"desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
"state": "NC",
"license": "2005-01398",
"primary": false
},
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "NC",
"license": "2005-01398",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5901841",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCBCBS",
"identifier": "140KC",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N98005",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.