Individual provider Active NPI

Michael Eric Dolberg, M.D.

  • Colon & Rectal Surgery Physician
  • Pembroke Pines, FL
National Provider Identifier
1811150204
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
ME113810 Issued in FL
Practice address
601 N Flamingo Rd
Suite 408
Pembroke Pines, FL 33028
Phone
(954) 844-1617
Fax
(954) 450-8584
NPI assigned
Jul 7, 2008
Last updated
Mar 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X ME113810 FL Primary

Addresses

Primary practice location

601 N Flamingo Rd
Suite 408
Pembroke Pines, FL 33028

Mailing address

2900 Corporate Way
MPG Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Other identifiers 1

IdentifierTypeStateIssuer
009168100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdolberg103784@MHSDIRECT.NET Direct

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
I20131021000114 FL Practitioner - General Surgery 2567697972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Miami, LM Miller School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

20801 Biscayne Blvd
Suite 203
Aventura, FL 33180-1492
Phone (954) 265-0072

601 N Flamingo Rd
Pembroke Pines, FL 33028-1012

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Sep 16, 2013 Accepting new patients
South Broward Hospital District Colon & Rectal Surgery CurrentSince Sep 16, 2013 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

20801 Biscayne Blvd
Ste 203
Aventura, FL 33180
Phone (305) 682-2580

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5663

601 N Flamingo Rd
Ste 411
Pembroke Pines, FL 33028
Phone (954) 265-2750

601 N Flamingo Rd
Ste 408
Pembroke Pnes, FL 33028
Phone (954) 265-3015

Interoperability endpoints

  • Direct secure messaging: mdolberg103784@mhsdirect.net

Organizations & group practices 3

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1811150204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "MPG DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N FLAMINGO RD",
            "address_2": "SUITE 408",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33028",
            "telephone_number": "954-844-1617",
            "fax_number": "954-450-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLBERG",
        "first_name": "MICHAEL",
        "middle_name": "ERIC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME113810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009168100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdolberg103784@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "601 N Flamingo Rd",
            "address_2": "Suite 408",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.