NPIMap

Organization Active NPI

North Broward Hospital District

Doing business as BGMC Cancer Center

  • Pediatric Hematology & Oncology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1881622850
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
Legal business name
NORTH BROWARD HOSPITAL DISTRICT
Doing business as
BGMC Cancer Center
Practice address
1600 S Andrews Avenue
Fort Lauderdale, FL 33316-2510
Phone
(954) 355-4527
Fax
(954) 712-6688
NPI assigned
Jun 29, 2006
Last updated
Apr 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH BROWARD HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Authorized official

Name
Alisa Bert
Title
Interim Cfo
Phone
(954) 847-4117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X NU Primary

Addresses

Primary practice location

1600 S Andrews Avenue
Fort Lauderdale, FL 33316-2510

Mailing address

1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 355-4527

Other identifiers 2

IdentifierTypeStateIssuer
253794002MedicaidFL
00020OtherFLBCBS OF FLA

Other names 1

  • BGMC CANCER CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001860 FL Part B Supplier - Clinic/Group Practice 3577472422 Receives reassigned benefits from 251 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
N Btroward Hospital Dis

Locations

1101 NW 1st St
Ft Lauderdale, FL 33311
Phone (954) 467-0880

1625 SE 3rd Ave
Ste 721
Ft Lauderdale, FL 33316
Phone (954) 355-4617

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1881622850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-355-4527",
            "fax_number": "954-712-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S ANDREWS AVENUE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162510",
            "telephone_number": "954-355-4527",
            "fax_number": "954-712-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH BROWARD HOSPITAL DISTRICT",
        "enumeration_date": "2006-06-29",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "BERT",
        "authorized_official_first_name": "ALISA",
        "authorized_official_title_or_position": "INTERIM CFO",
        "authorized_official_telephone_number": "954-847-4117"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253794002",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLA",
            "identifier": "00020",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BGMC CANCER CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.