NPIMap

Organization Active NPI

Orthopaedic & Sports Medicine Center of Miami PA

  • Non-Pharmacy Dispensing Site
  • South Miami, FL
National Provider Identifier
1033255641
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
ME58988 Issued in FL
Legal business name
ORTHOPAEDIC & SPORTS MEDICINE CENTER OF MIAMI PA
Practice address
6701 Sunset Dr
Suite 201
South Miami, FL 33143-4529
Phone
(305) 661-7601
Fax
(305) 661-0154
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

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

Authorized official

Name
Kimberly Bockman
Title
Manager
Phone
(305) 661-7601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X ME58988 FL Primary

Addresses

Primary practice location

6701 Sunset Dr
Suite 201
South Miami, FL 33143-4529

Mailing address

PO Box 430430
South Miami, FL 33243-0430
Phone (305) 661-7601

Other identifiers 8

IdentifierTypeStateIssuer
159502800OtherFLUS DEPARTMENT OF LABOR
7890258OtherFLAETNA
209485OtherFLAVMED
2316780OtherFLUNITED HEALTHCARE
1024417OtherOTHER ID NUMBER-COMMERCIAL NUMBER
1033255641OtherFLCIGNA
000623OtherFLNEIGHBORHOOD HEALTH PLAN
39759OtherFLBLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040403000074 FL Part B Supplier - Clinic/Group Practice 5496748832 Receives reassigned benefits from 3 practitioners
Practice locations: South Miami, FL

National Provider Directory

National Provider Directory

Locations

6701 Sunset Dr
Ste 201
South Miami, FL 33143
Phone (305) 661-7601

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383177600000",
    "number": "1033255641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430430",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "332430430",
            "telephone_number": "305-661-7601",
            "fax_number": "305-661-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 SUNSET DR",
            "address_2": "SUITE 201",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434529",
            "telephone_number": "305-661-7601",
            "fax_number": "305-661-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC & SPORTS MEDICINE CENTER OF MIAMI PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2013-10-31",
        "status": "A",
        "authorized_official_last_name": "BOCKMAN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "305-661-7601"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "ME58988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "159502800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7890258",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "209485",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2316780",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1024417",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1033255641",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "000623",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "39759",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.