NPIMap

Organization Active NPI

Pro Medical East LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Lauderdale, FL
National Provider Identifier
1952575953
Registry record updated Jan 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
6000006633 Issued in PA
Legal business name
PRO MEDICAL EAST LLC
Practice address
6555 Powerline Rd
Suite 101
Fort Lauderdale, FL 33309-2067
Phone
(954) 677-1011
Fax
(954) 677-0922
NPI assigned
Apr 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2011

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

Authorized official

Name
Mr. John Francis Dimarco, CERTIFIED PEDORTHIST
Title
Managing Partner
Phone
(610) 525-3162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 6000006633 PA Primary

Addresses

Primary practice location

6555 Powerline Rd
Suite 101
Fort Lauderdale, FL 33309-2067

Mailing address

6555 Powerline Rd
Suite 101
Fort Lauderdale, FL 33309-2067
Phone (954) 677-1011

Other identifiers 16

IdentifierTypeStateIssuer
408730500MedicaidMD
540H104220OtherMIMICHIGAN BC/BS
P2723785OtherAETNA
0005164000OtherKEYSTONE EAST
200068890AMedicaidOK
82839600MedicaidWI
8704805MedicaidNJ
90003799MedicaidKY
DM1174MedicaidSC
2272955MedicaidOH
000246014OtherHIGHMARK BC/BS
4344350MedicaidMI
625683800MedicaidMN
0005164000OtherAMERIHEALTH
0018611300003MedicaidPA
4582539MedicaidTN

Other names 1

  • Professional Medical Enterprises LLC Other name

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

6555 Powerline Rd
Ste 101
Fort Lauderdale, FL 33309
Phone (954) 677-1011

336 King of Prussia Rd
Ste 101
Radnor, PA 19087

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296086400000",
    "number": "1952575953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 POWERLINE RD",
            "address_2": "SUITE 101",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092067",
            "telephone_number": "954-677-1011",
            "fax_number": "954-677-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 POWERLINE RD",
            "address_2": "SUITE 101",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092067",
            "telephone_number": "954-677-1011",
            "fax_number": "954-677-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO MEDICAL EAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2011-01-27",
        "status": "A",
        "authorized_official_last_name": "DIMARCO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "610-525-3162",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CERTIFIED PEDORTHIST"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "6000006633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408730500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN BC/BS",
            "identifier": "540H104220",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "P2723785",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE EAST",
            "identifier": "0005164000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200068890A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82839600",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8704805",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90003799",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DM1174",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2272955",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC/BS",
            "identifier": "000246014",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4344350",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "625683800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0005164000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018611300003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4582539",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Medical Enterprises LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.