Individual provider Active NPI

Mehdi Bouslama

  • Vascular Neurology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1942732680
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
ME166470 Issued in FL
Practice address
1601 S Andrews Ave FL 3
Fort Lauderdale, FL 33316-2509
Phone
(954) 763-6655
Fax
(954) 763-6799
NPI assigned
Mar 31, 2017
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X ME166470 FL Primary

Addresses

Primary practice location

1601 S Andrews Ave FL 3
Fort Lauderdale, FL 33316-2509

Mailing address

1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 763-6655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220831003345 NY Practitioner - Neurosurgery 8628348711 Reassigns benefits to 1 organization
I20240624000324 FL Practitioner - Neurology 8628348711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Broward Hospital DistrictGroup PAC ID 3577472422, 192 clinicians

Practice addresses (Care Compare)

1601 S Andrews Ave
FL 3
Fort Lauderdale, FL 33316-2509
Phone (954) 763-6655

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME166470FLMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University at Buffalo Neurosurgery, Inc. CurrentSince Jul 1, 2022 Accepting new patients
University at Buffalo Neurosurgery, Inc. CurrentSince Jul 1, 2022 Accepting new patients
North Broward Hospital District CurrentSince Aug 12, 2024 Accepting new patients
North Broward Hospital District Current Accepting new patients
North Broward Hospital District CurrentSince Aug 12, 2024 Accepting new patients
North Broward Hospital District Past Accepting new patients
North Broward Hospital District Past Accepting new patients

Locations

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

1601 S Andrews Ave
Fl 3
Ft Lauderdale, FL 33316
Phone (954) 320-3380

1700 NW 49th St
Ste 125
Ft Lauderdale, FL 33309
Phone (954) 355-3490

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

Networks

  • Freedom Health HMO Network

Organizations & group practices 7

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 1

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": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1942732680",
    "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": "954-763-6655",
            "fax_number": "954-763-6799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 S ANDREWS AVE FL 3",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162509",
            "telephone_number": "954-763-6655",
            "fax_number": "954-763-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSLAMA",
        "first_name": "MEHDI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-31",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "FL",
            "license": "ME166470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.