Active NPI
Jesica Bromberg Shienbaum, MD
- Obstetrics & Gynecology Physician
- Hollywood, FL
National Provider Identifier
1073706107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MT190080
- Practice address
- 4100 Hollywood Blvd
2ND Floor
Hollywood, FL 33021-6778 - Phone
- (954) 518-4100
- NPI assigned
- Aug 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MT190080 | PA | Primary |
Addresses
Primary practice location
4100 Hollywood Blvd
2ND Floor
Hollywood, FL 33021-6778
Mailing address
4100 Hollywood Blvd
2ND Floor
Hollywood, FL 33021-6778
Phone (954) 518-4100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Pennsylvania State University College of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4100 Hollywood Blvd
Suite 2
Hollywood, FL 33021-6778
Phone (954) 518-4100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT190080 | PA | MD | Obstetrics & Gynecology Physician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Obstetrics & Gynecology Physician
- Miami, FL
- NPI 1871572032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315440000000",
"number": "1073706107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 HOLLYWOOD BLVD",
"address_2": "2ND FLOOR",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330216778",
"telephone_number": "954-518-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 HOLLYWOOD BLVD",
"address_2": "2ND FLOOR",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330216778",
"telephone_number": "954-518-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIENBAUM",
"first_name": "JESICA",
"middle_name": "BROMBERG",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-22",
"last_updated": "2011-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "PA",
"license": "MT190080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.