NPIMap

Individual provider Active NPI

Theresa Redoble Fortaleza-Dawson, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Fort Lauderdale, FL
National Provider Identifier
1871507780
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
ME81298 Issued in FL
Practice address
2006 NE 49TH St
Ft Lauderdale, FL 33308-4524
Phone
(954) 938-8998
Fax
(954) 938-8984
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME81298 FL Primary

Addresses

Primary practice location

2006 NE 49TH St
Ft Lauderdale, FL 33308-4524

Mailing address

6278 N Federal Hwy
#183
Ft Lauderdale, FL 33308-1916
Phone (954) 938-8998

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040308000045 FL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 5395633093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1880 E Commercial Blvd
Suite 3
Ft Lauderdale, FL 33308-3747

4801 N Federal Hwy
Suite 202
Fort Lauderdale, FL 33308-4618
Phone (954) 938-8998

6278 N Federal Hwy
Suite 183
Ft Lauderdale, FL 33308-1916

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.01 of 100Reported as individual
Quality
78.2
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Theresa Fortaleza-Dawson MD PA Geriatric Medicine CurrentSince Sep 15, 2003 Accepting new patients

Locations

2006 NE 49th St
Ft Lauderdale, FL 33308
Phone (954) 210-4120

6278 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 941-4388

1880 E Commercial Blvd
Ste 3
Ft Lauderdale, FL 33308
Phone (954) 650-7666

4801 N Federal Hwy
Ste 202
Ft Lauderdale, FL 33308
Phone (954) 771-9297

Organizations & group practices 1

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871507780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6278 N FEDERAL HWY",
            "address_2": "#183",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081916",
            "telephone_number": "954-938-8998",
            "fax_number": "954-938-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 NE 49TH ST",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084524",
            "telephone_number": "954-938-8998",
            "fax_number": "954-938-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTALEZA-DAWSON",
        "first_name": "THERESA",
        "middle_name": "REDOBLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME81298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.