PHOENIX EMERGENCY MEDICINE OF BROWARD LLC – Emergency Medicine Physician, NPI 1992708887
Emergency Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for PHOENIX EMERGENCY MEDICINE OF BROWARD LLC
Broward Health Medical Center, 1600, South Andrews Avenue, Fort Lauderdale, Broward County, Florida, 33316, United States
FT LAUDERDALE, FL 333162510
Phone: (954) 939-5000
Fax: (484) 342-5201
Type: Location
PO BOX 38048
PHILADELPHIA, PA 191010813
Phone: (954) 939-5000
Fax: (484) 342-5201
Type: Mailing
3114, Croasdaile Drive, Hillandale Commons, Croasdaile, Durham, Durham County, North Carolina, 27705, United States
SUITE 200
DURHAM, NC 277052508
Phone: (954) 838-2371
Type: Mailing
5565 CENTERVIEW DR STE 107
RALEIGH, NC 276063563
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
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 |
|---|---|---|---|---|
| O20040505001132 | O | Clinic/Group Practice | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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 33316)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.