Individual provider Active NPI

Michelle Dzung, DO

  • Family Medicine Physician
  • Lighthouse Point, FL
National Provider Identifier
1912460064
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS18855 Issued in FL
Practice address
2850 N Federal Hwy
Lighthouse Point, FL 33064-6849
Phone
(954) 942-8177
NPI assigned
Apr 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X OS18855 FL Primary

Addresses

Primary practice location

2850 N Federal Hwy
Lighthouse Point, FL 33064-6849

Mailing address

2850 N Federal Hwy
Lighthouse Point, FL 33064-6849
Phone (954) 942-8177

Other practice location 1

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
Phone (954) 712-6356

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
I20220726000382 FL Practitioner - Family Practice 8426439282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Campbell Univ School of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holy Cross Hospital IncGroup PAC ID 1850298365, 299 clinicians

Practice addresses (Care Compare)

1309 S Federal Hwy
Holy Cross Medical Group
Fort Lauderdale, FL 33316-2040
Phone (954) 463-4383

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS18855FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital, Inc CurrentSince Jul 20, 2022 Accepting new patients
Holy Cross Hospital Inc Family Medicine CurrentSince Jul 20, 2022 Accepting new patients

Locations

1900 E Commercial Blvd
Ste 101
Ft Lauderdale, FL 33308
Phone (954) 351-5838

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

2850 N Federal Hwy
Pompano Beach, FL 33064
Phone (954) 785-8285

Interoperability endpoints

  • Direct secure messaging: mdzung2126726@direct.trinity-health.org

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1554508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1912460064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 N FEDERAL HWY",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330646849",
            "telephone_number": "954-942-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 N FEDERAL HWY",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330646849",
            "telephone_number": "954-942-8177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 S Andrews Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333162510",
            "country_code": "US",
            "telephone_number": "954-712-6356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DZUNG",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-06",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS18855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lighthouse Point, FL

Sources for this page

Verify at the official NPI Registry.