Individual provider Active NPI

Mark S Dorfman, M.D.

  • Ophthalmology Physician
  • Hollywood, FL
National Provider Identifier
1962499376
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME0065865 Issued in FL
Practice address
300 S Park Rd Ste 300
Hollywood, FL 33021-8353
Phone
(954) 925-2740
Fax
(954) 923-8379
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME0065865 FL Primary

Addresses

Primary practice location

300 S Park Rd Ste 300
Hollywood, FL 33021-8353

Mailing address

300 S Park Rd Ste 300
Hollywood, FL 33021-8353
Phone (954) 925-2740

Other identifiers 1

IdentifierTypeStateIssuer
375515100MedicaidFL

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
ME0065865FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Surgery Associates LLC Past Accepting new patients
Rop Consultants of South Florida, PA. Ophthalmology Past Accepting new patients

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mark.dorfman.p3@direct.drea.nextgenshare.com
  • Direct secure messaging: mdorfman13072@mhsdirect.net

Organizations & group practices 2

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1962499376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S PARK RD STE 300",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218353",
            "telephone_number": "954-925-2740",
            "fax_number": "954-923-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S PARK RD STE 300",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218353",
            "telephone_number": "954-925-2740",
            "fax_number": "954-923-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORFMAN",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0065865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375515100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.