Memorial Division of Vascular Surgery – Vascular Surgery Physician, NPI 1366785743
Vascular Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Memorial Division of Vascular Surgery
1150 N 35TH AVENUE
STE 460
HOLLYWOOD, FL 33021
Phone: (954) 265-4664
Fax: (954) 265-8373
Type: Location
2301 N University Dr Ste 211
Pembroke Pines, FL 330243617
Phone: (954) 844-4664
Fax: (954) 844-4669
Type: Location
1150 N 35th Ave Ste 440
Hollywood, FL 330215430
Phone: (954) 265-4664
Fax: (954) 265-8373
Type: Location
601 N Flamingo Rd Ste 202
Pembroke Pines, FL 330281008
Phone: (954) 265-4664
Fax: (954) 265-8373
Type: Location
1951 SW 172nd Ave Ste 404
Miramar, FL 330295614
Phone: (954) 264-4664
Fax: (954) 265-8373
Type: Location
2900 CORPORATE WAY
DOOR D
MIRAMAR, FL 33025
Phone: (954) 276-5685
Fax: (954) 985-7074
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-11-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-01-31 (127 days ago).
Enrollment records
1
Earliest due date
2026-01-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20161102000607 | O | Clinic/Group Practice | FL | 2026-01-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33021)
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