Individual provider Active NPI

Thomas MJ Niederman, MD,PHD

  • Specialist
  • Boynton Beach, FL
National Provider Identifier
1992762868
Registry record updated Apr 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME80006 Issued in FL
Practice address
2240 W Woolbright Rd
Suite 415
Boynton Beach, FL 33426-6332
Phone
(561) 737-6556
NPI assigned
Apr 26, 2006
Last updated
Apr 7, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME80006 FL Primary

Addresses

Primary practice location

2240 W Woolbright Rd
Suite 415
Boynton Beach, FL 33426-6332

Mailing address

2240 W Woolbright Rd
Suite 415
Boynton Beach, FL 33426-6332
Phone (561) 737-6556

Other identifiers 1

IdentifierTypeStateIssuer
258728900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040416001167 FL Practitioner - Medical OncologyPractitioner - Hematology/Oncology 2567457716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Washington University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2240 W Woolbright Rd
Suite 415
Boynton Beach, FL 33426-6367
Phone (561) 737-6556

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME80006FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
University Cancer Institute LLC Specialist CurrentSince Dec 16, 2005 Accepting new patients

Locations

2240 W Woolbright Rd
Ste 415
Boynton Beach, FL 33426
Phone (561) 737-6556

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270598400000",
    "number": "1992762868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 W WOOLBRIGHT RD",
            "address_2": "SUITE 415",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334266332",
            "telephone_number": "561-737-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 W WOOLBRIGHT RD",
            "address_2": "SUITE 415",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334266332",
            "telephone_number": "561-737-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDERMAN",
        "first_name": "THOMAS",
        "middle_name": "MJ",
        "credential": "MD,PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2010-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME80006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258728900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.