Individual provider Active NPI

Mark Sandhouse, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Davie, FL
National Provider Identifier
1780640862
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
OS0005718 Issued in FL
Practice address
3200 S University Dr
Suite 4316
Davie, FL 33328-2018
Phone
(954) 262-4316
Fax
(954) 262-3538
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS0005718 FL
Neuromusculoskeletal Medicine & OMM Physician 204D00000X OS0005718 FL Primary

Addresses

Primary practice location

3200 S University Dr
Suite 4316
Davie, FL 33328-2018

Mailing address

3200 S University Dr
Suite 4316
Davie, FL 33328-2018
Phone (954) 262-4316

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://login.intelichart.com/NSUHealthClinics/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111028000639 FL Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 4284807728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Nova Southeastern College of Osteo Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nova Southeastern University IncGroup PAC ID 4486568896, 97 clinicians

Practice addresses (Care Compare)

3200 S University Dr
Daive, FL 33328-2018
Phone (954) 262-9417

650 N Andrews Ave
Eye Institute
Ft Lauderdale, FL 33311-7436
Phone (954) 262-4343

Merit-based Incentive Payment System (MIPS)

Final score
72.47 of 100Reported as group
Quality
62.45
Improvement activities
40
Cost
73.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS0005718FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University Inc. CurrentSince Jul 7, 1989 Accepting new patients
Nova Southeastern University, Inc CurrentSince Jul 7, 1989 Accepting new patients
Nova Southeastern University, Inc Current Accepting new patients
Nova Southeastern University, Inc Neuromusculoskeletal Medicine & Omm Past Accepting new patients

Locations

3200 S University Dr
Ste 4316
Davie, FL 33328
Phone (954) 262-4316

3200 S University Dr
Bldg 2ND
Davie, FL 33328
Phone (954) 262-4200

3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1780640862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "address_2": "SUITE 4316",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4316",
            "fax_number": "954-262-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "address_2": "SUITE 4316",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4316",
            "fax_number": "954-262-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHOUSE",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0005718",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "FL",
            "license": "OS0005718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://login.intelichart.com/NSUHealthClinics/",
            "affiliation": "N",
            "address_1": "3200 S University Dr",
            "address_2": "Suite 4316",
            "city": "Davie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333282018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.