Individual provider Active NPI

David L Andrisani, D.O.

  • Family Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1811920895
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS8580 Issued in FL
Practice address
15800 Pines Blvd
# 329
Pembroke Pines, FL 33027-1212
Phone
(954) 662-5005
NPI assigned
Jul 10, 2006
Last updated
Nov 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS8580 FL Primary

Addresses

Primary practice location

15800 Pines Blvd
# 329
Pembroke Pines, FL 33027-1212

Mailing address

15800 Pines Blvd
# 329
Pembroke Pines, FL 33027-1212
Phone (954) 662-5005

Other identifiers 1

IdentifierTypeStateIssuer
269849800MedicaidFL

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
I20040623001505 FL Practitioner - Family Practice 1557346350 Practice locations: Pembroke Pines, FL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15800 Pines Blvd
Pembroke Pines, FL 33027-1212
Phone (954) 662-5005

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue178
Removal of skin lesions11

National Provider Directory

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

Hospital & facility affiliations 5

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1811920895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15800 PINES BLVD",
            "address_2": "# 329",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271212",
            "telephone_number": "954-662-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15800 PINES BLVD",
            "address_2": "# 329",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271212",
            "telephone_number": "954-662-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRISANI",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS8580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269849800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.