Joseph Haider, D.O.
Individual provider Active NPI Family Medicine Physician · Bradenton, FL
NPI 1962943746 · NPPES record last updated Jul 9, 2020
Key facts
- NPI
- 1962943746
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- OS16845 (FL)
- Practice address
- 5123 4TH Avenue Cir E
Bradenton, FL 34208-5620 - Phone
- (941) 744-5510
- NPI assigned
- Mar 14, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 13
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Legacy Healthcare Services Inc
Cooper Family Medical PLLC
H2 Rehabilitation Services of Florida LLC
Practice addresses (Care Compare)
17470 Brookside Trace CT
Tampa, FL 33647-6201
Phone (813) 443-5042
5123 4TH Ave Cir E
Bradenton, FL 34208-5620
Phone (941) 744-5510
8220 Natures Way
Apt 201
Lakewood Ranch, FL 34202-4208
Phone (800) 699-9395
Hospital & facility affiliations
- Pinnacle Home Care
- HCA Florida Healthcare at Home
- Vitalcaring Group
- Amedisys Home Health
- Patients First Home Care LLC
- Empath Tidewell Hospice
- Manatee Memorial Hospital
- Lakewood Ranch Medical Center
- Sarasota Memorial Hospital
- HCA Florida Blake Hospital
- Inn at Freedom Village, the
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| The Inn at Freedom Village |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jan 1, 2025 Apr 10, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200716003625 | FL | Practitioner - Family Practice | 2668896101 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS16845 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cooper Family Medical PLLC | Family Medicine | Current |
Accepting new patients |
| CCRC Opco - Bradenton, LLC | Past | Accepting new patients |
Locations
5123 4th Avenue Cir E
Bradenton, FL 34208
Phone (941) 744-5510
Interoperability endpoints
- https://api.platform.athenahealth.com/26999/brand/2/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS16845 | FL | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X | FL |
Addresses
Primary practice location
5123 4TH Avenue Cir E
Bradenton, FL 34208-5620
Mailing address
5123 4TH Avenue Cir E
Bradenton, FL 34208-5620
Phone (720) 630-0984
Other providers in Bradenton, FL
- Debbie Lynn Hage
- Travis R. Hage
- Mark R Hager
- Alexander Robert Haggerty
- Abdullah Tamin Haider
- Hairston Nutrition Consulting PLLC
- Veronica D Hairston
- Ranjay Halder
- Dennis M Hale
- Aimee Suzanne Hall
All providers in Bradenton, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.