Individual provider Active NPI

Robin Gayle Simon-Mark, D.O.

  • Orthopaedic Surgery Physician
  • Hollywood, FL
National Provider Identifier
1053359919
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
OS7659 Issued in FL
Practice address
2607 Polk St
Hollywood, FL 33020
Phone
(954) 925-7333
Fax
(954) 925-7339
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X OS7659 FL Primary

Addresses

Primary practice location

2607 Polk St
Hollywood, FL 33020

Mailing address

2607 Polk St
Hollywood, FL 33020-4822
Phone (954) 925-7333

Other identifiers 1

IdentifierTypeStateIssuer
256295200MedicaidFL

Other names 1

  • Dr. Robin G. Simon Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081018000118 FL Practitioner - Orthopedic Surgery 1456383801 Reassigns benefits to 1 organization
I20250304001249 NC Practitioner - Orthopedic Surgery 1456383801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Broward Medical and Rehab IncGroup PAC ID 0840326104, 2 clinicians
DLP Western Carolina Physician Practices LLCGroup PAC ID 9032338975, 177 clinicians

Practice addresses (Care Compare)

5000 W Oakland Park Blvd
Lauderdale Lakes, FL 33313-1503
Phone (954) 735-6000

581 Leroy George Dr
Suite 300
Clyde, NC 28721-8085
Phone (828) 452-4131

Hospital & facility affiliations

  • Haywood Regional Medical Center Hospital, Clyde, NC, CCN 340184
  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS7659FLMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Broward Medical & Rehab Inc Orthopaedic Surgery CurrentSince Feb 25, 2013 Accepting new patients
DLP Western Carolina Physician Practices LLC CurrentSince Nov 15, 2024 Accepting new patients
DLP Western Carolina Physician Practices LLC Orthopaedic Surgery CurrentSince Nov 15, 2024 Accepting new patients
Ortho Florida, LLC Orthopaedic Surgery Past Accepting new patients
Texas Regional Medical Center, LLC PastSince Apr 11, 2009 Accepting new patients

Locations

2607 Polk St
Hollywood, FL 33020
Phone (954) 925-4001

5000 W Oakland Park Blvd
Lauderdale Lakes, FL 33313
Phone (866) 747-5834

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

4101 NW 4th St
Ste 305
Plantation, FL 33317
Phone (954) 370-7040

1776 N Pine Island Rd
Ste 216
Plantation, FL 33322
Phone (954) 583-8130

581 Leroy George Dr
Ste 300
Clyde, NC 28721
Phone (828) 452-4131

98 Doctors Dr
Ste 200
Sylva, NC 28779
Phone (828) 586-8971

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1053359919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 POLK ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204822",
            "telephone_number": "954-925-7333",
            "fax_number": "954-925-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 POLK ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33020",
            "telephone_number": "954-925-7333",
            "fax_number": "954-925-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON-MARK",
        "first_name": "ROBIN",
        "middle_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "OS7659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256295200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBIN",
            "last_name": "SIMON",
            "middle_name": "G.",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.