53RD STREET MEDICAL GROUP, LLC — NPI 1962767202 (Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) in FT LAUDERDALE, FL)

CMS-1500 Box 24J / 33a • NPI

1962767202

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

2084A0401X (CMS 79)

Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)

Box 32 Service Location & ZIP+4

2331 NE 53RD ST, FT LAUDERDALE, FL, 33308-3235

✓ 9-Digit EDI 837 ZIP+4 (33308-3235)

Practice Phone & Referral Fax

(954) 491-9700

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1962767202 (53RD STREET MEDICAL GROUP, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1962767202` (NPI-2 Organization / Facility)
Provider / Legal Name	53RD STREET MEDICAL GROUP, LLC
Plain-English Specialty	Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) NUCC Code: `2084A0401X` (Psychiatry & Neurology, Addiction Medicine)
Certifying / Licensing Body	American Board of Psychiatry and Neurology (ABPN)
Practice Location Address	2331 NE 53RD ST, FT LAUDERDALE, FL, 33308-3235
Practice Telephone / Fax	Tel: (954) 491-9700
Administrative Mailing Address	PO BOX 7240, JUPITER, FL, 33468-7240
Enumeration & Last Sync	Enumerated: 2012-07-12 \| CMS Record Updated: 2012-08-01
Authorized Official	KAREN BARLOW (President, Jupiter Professional Dev)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2331 NE 53RD ST, FT LAUDERDALE, FL, 33308-3235

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Plain-English Taxonomy & CMS Crosswalk (2084A0401X)

What Does Taxonomy Code 2084A0401X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2084A0401X translates to:
"Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 79 (Physician/Addiction Medicine) • CMS Code 86 (Physician/Neuropsychiatry)
Certifying / Accrediting Authority: American Board of Psychiatry and Neurology (ABPN)
Clinical Scope: Stroke recovery, chronic or severe migraines, seizures, numbness/tingling in hands or feet (neuropathy), tremors, memory loss, or suspected CSF leak.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (53RD STREET MEDICAL GROUP, LLC)

Typical CPT / Diagnostic Procedures:

Electroencephalography (EEG — CPT 95816) for Seizure & Epilepsy Evaluation
Electromyography (EMG) & Nerve Conduction Studies (NCS)
Lumbar Puncture & Cerebrospinal Fluid (CSF) Pressure/Analysis
Acute Ischemic Stroke NIHSS Assessment & Neuroimaging Review

Common Therapeutic Classes:

CGRP Antagonists & Triptans (Sumatriptan, Rizatriptan) for Migraine
Antiepileptic Drugs (Levetiracetam, Lamotrigine, Valproate)
Levodopa/Carbidopa (Parkinson's Disease) & Gabapentin/Pregabalin (Neuropathy)
Antiplatelet & Secondary Stroke Prevention Regimens

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`2084A0401X` — Psychiatry & Neurology, Addiction Medicine Plain English: Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)	State: FL \| License: `ME83014` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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53RD STREET MEDICAL GROUP, LLC (NPI #1962767202)