Individual provider Active NPI

Jay B Fine, M.D.

  • Plastic Surgery Physician
  • Pembroke Pines, FL
National Provider Identifier
1952344863
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
ME25699 Issued in FL
Practice address
601 N Flamingo Rd
Ste 403
Pembroke Pines, FL 33028-1015
Phone
(954) 436-0244
Fax
(954) 374-8855
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X ME25699 FL Primary

Addresses

Primary practice location

601 N Flamingo Rd
Ste 403
Pembroke Pines, FL 33028-1015

Mailing address

601 N Flamingo Rd
Suite 403
Pembroke Pines, FL 33028-1015
Phone (954) 436-0244

Other identifiers 3

IdentifierTypeStateIssuer
228876OtherFLAVMED
854177OtherFLAETNA
78422OtherFLBLUE CROSS & BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME25699FLMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hyperbaric Associates of Florida P a Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1952344863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N FLAMINGO RD",
            "address_2": "SUITE 403",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281015",
            "telephone_number": "954-436-0244",
            "fax_number": "954-374-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N FLAMINGO RD",
            "address_2": "STE 403",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281015",
            "telephone_number": "954-436-0244",
            "fax_number": "954-374-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "JAY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME25699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "228876",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "854177",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "78422",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.