Individual provider Active NPI

Todd Daniel Thomason, ARNP, NP-C

  • Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1912900960
Registry record updated Mar 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN9176643 Issued in FL
Practice address
2350 N University Dr Unit 841423
Pembroke Pines, FL 33084-4106
Phone
(954) 383-8836
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN9176643 FL Primary

Addresses

Primary practice location

2350 N University Dr Unit 841423
Pembroke Pines, FL 33084-4106

Mailing address

2350 N University Dr Unit 841423
Pembroke Pines, FL 33084-4106
Phone (954) 383-8836

Other identifiers 2

IdentifierTypeStateIssuer
303896300MedicaidFL
Y006QOtherFLBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 9543838836 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040909000784 FL Practitioner - Nurse Practitioner 9032185137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1901 SW 172 Ave
Miramar, FL 33029-5592
Phone (954) 538-5000

7800 Sheridan St
Pembroke Pines, FL 33024-2536
Phone (954) 962-9650

Hospital & facility affiliations

  • Memorial Hospital Pembroke Hospital, Pembroke Pines, FL, CCN 100230
  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9176643FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Todd D Thomason NPC Inc Nurse Practitioner CurrentSince Aug 1, 2007 Accepting new patients
Prohealth Select, Inc. Nurse Practitioner PastSince Dec 17, 2020 Accepting new patients
PA Surgical Inc Nurse Practitioner PastSince Sep 27, 2020 Accepting new patients
Radiology Associates of Hollywood, Inc. Past Accepting new patients

Locations

1901 SW 172nd Ave
Miramar, FL 33029
Phone (954) 276-5401

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

2350 N University Dr
Unit 841423
Pembroke Pines, FL 33084
Phone (954) 383-8836

Interoperability endpoints

  • Direct secure messaging: tthomason13813@mhsdirect.net

Organizations & group practices 4

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 2

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615680000000",
    "number": "1912900960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 N UNIVERSITY DR UNIT 841423",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330844106",
            "telephone_number": "954-383-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N UNIVERSITY DR UNIT 841423",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330844106",
            "telephone_number": "954-383-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMASON",
        "first_name": "TODD",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "ARNP, NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2021-03-14",
        "certification_date": "2021-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "RN9176643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303896300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y006Q",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "9543838836",
            "affiliation": "N",
            "endpointDescription": "Cell",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cell",
            "address_1": "2350 N University Dr Unit 841423",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330844106",
            "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.