Individual provider Active NPI

Andrew E Nullman, M.D.

  • Gastroenterology Physician
  • Miami, FL
National Provider Identifier
1912939208
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME51981 Issued in FL
Practice address
1190 NW 95TH St Ste 412
Miami, FL 33150-2067
Phone
(305) 534-4404
Fax
(305) 691-4449
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME51981 FL Primary

Addresses

Primary practice location

1190 NW 95TH St Ste 412
Miami, FL 33150-2067

Mailing address

1190 NW 95TH St Ste 412
Miami, FL 33150-2067
Phone (305) 534-4404

Other identifiers 1

IdentifierTypeStateIssuer
053552400MedicaidFL

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
I20040203000963 FL Practitioner - Gastroenterology 8224921325 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Venture Gastroenterology LLCGroup PAC ID 0345493672, 2 clinicians

Practice addresses (Care Compare)

16855 NE 2 Ave
Suite 300
North Miami Beach, FL 33162-1744
Phone (305) 654-4488

Hospital & facility affiliations

  • North Shore Medical Center Hospital, Miami, FL, CCN 100029

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy30
Upper gastrointestinal (GI) endoscopy for acid reflux21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME51981FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Venture Gastroenterology LLC Gastroenterology CurrentSince Sep 4, 2012 Accepting new patients
Andrew E Nullman MD PA Gastroenterology CurrentSince Sep 11, 2006 Accepting new patients
Venture Gastroenterology LLC Gastroenterology CurrentSince Sep 4, 2012 Accepting new patients

Locations

1740 E Hallandale Beach Blvd
Hallandale Beach, FL 33009
Phone (305) 933-3170

1190 NW 95th St
Ste 412
Miami, FL 33150
Phone (305) 534-4404

4302 Alton Rd
Ste 660
Miami Beach, FL 33140
Phone (305) 534-4404

4302 Alton Rd
Ste 760
Miami Beach, FL 33140
Phone (305) 329-2900

1100 NW 95th St
Miami Shores, FL 33150
Phone (305) 835-6000

16855 NE 2nd Ave
Ste 300
North Miami Beach, FL 33162
Phone (305) 534-4404

65 NW 168th St
North Miami Beach, FL 33169
Phone (305) 653-6365

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: andrew.nullman.1@3165.direct.athenahealth.com
  • Direct secure messaging: andrew.nullman.9@3165.direct.athenahealth.com

Organizations & group practices 3

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1912939208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 NW 95TH ST STE 412",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331502067",
            "telephone_number": "305-534-4404",
            "fax_number": "305-691-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 NW 95TH ST STE 412",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331502067",
            "telephone_number": "305-534-4404",
            "fax_number": "305-691-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NULLMAN",
        "first_name": "ANDREW",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME51981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053552400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.