Individual provider Active NPI

Maria Del Rosario Ciccia, MD

  • Radiation Oncology Physician
  • Hollywood, FL
National Provider Identifier
1083617211
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ME72617 Issued in FL
Practice address
3501 Johnson St FL 1
Hollywood, FL 33021-5421
Phone
(954) 265-8000
Fax
(954) 276-0471
NPI assigned
May 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X ME72617 FL Primary

Addresses

Primary practice location

3501 Johnson St FL 1
Hollywood, FL 33021-5421

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Other practice location 1

801 N Flamingo Rd Ste 10
Pembroke Pines, FL 33028-1019
Phone (954) 844-9696

Other identifiers 1

IdentifierTypeStateIssuer
255886600MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mciccia13449@MHSDIRECT.NET

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040115000408 FL Practitioner - Radiation Oncology 5991606774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

3501 Johnson St
FL 1
Hollywood, FL 33021-5421
Phone (954) 265-8000

Hospital & facility affiliations

  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME72617FLMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Jan 1, 2024 Accepting new patients
South Broward Hospital District Radiation Oncology CurrentSince Jan 1, 2024 Accepting new patients
South Broward Hospital District Past Accepting new patients
Radiology Associates of Hollywood, Inc. Past Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

3501 Johnson St
Fl 1
Hollywood, FL 33021
Phone (954) 265-7750

1005 N 35th Ave
Hollywood, FL 33021
Phone (954) 265-5324

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

12235 Pines Blvd
Pembroke Pines, FL 33026
Phone (954) 265-1125

801 N Flamingo Rd
Ste 10
Pembroke Pines, FL 33028
Phone (954) 844-9696

Interoperability endpoints

  • Direct secure messaging: mciccia13449@mhsdirect.net

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 1

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1083617211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST FL 1",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-265-8000",
            "fax_number": "954-276-0471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 N Flamingo Rd Ste 10",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281019",
            "country_code": "US",
            "telephone_number": "954-844-9696",
            "fax_number": "954-450-4422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CICCIA",
        "first_name": "MARIA",
        "middle_name": "DEL ROSARIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME72617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255886600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mciccia13449@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "3501 Johnson St Fl 1",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.