Individual provider Active NPI

Michael Rosselli

  • Sports Medicine (Emergency Medicine) Physician
  • South Miami, FL
National Provider Identifier
1083851356
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X
License
ME111396 Issued in FL
Practice address
5966 S Dixie Hwy Ste 401
South Miami, FL 33143-5177
Phone
(786) 453-2667
NPI assigned
Jan 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Emergency Medicine) Physician 207PS0010X ME111396 FL Primary
Emergency Medicine Physician 207P00000X 252635 NY

Addresses

Primary practice location

5966 S Dixie Hwy Ste 401
South Miami, FL 33143-5177

Mailing address

5966 S Dixie Hwy Ste 401
South Miami, FL 33143-5177
Phone (786) 453-2667

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
I20111115000600 FL Practitioner - Emergency MedicinePractitioner - Sports Medicine 0648326165 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Sports Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabclinics Pta IncGroup PAC ID 0547237497, shared by 11 NPIs, 209 clinicians
Ortho Florida LLCGroup PAC ID 3274616453, 121 clinicians

Practice addresses (Care Compare)

13645 Biscayne Blvd
North Miami Beach, FL 33181-1617
Phone (305) 949-2700

1601 Clint Moore Rd
Suite 125
Boca Raton, FL 33487-5714
Phone (561) 939-0800

5966 S Dixie Hwy
Suite 401
South Miami, FL 33143-5177
Phone (786) 453-2667

660 Glades Rd
Suite 360
Boca Raton, FL 33431-6469
Phone (561) 391-5515

Hospital & facility affiliations

  • Mount Sinai Medical Center of Florida, Inc Hospital, Miami Beach, FL, CCN 100034

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
252635NYMDEmergency Medicine Physician
ME111396FLMDSports Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Emergency Services of Miami Beach PA Emergency Medicine CurrentSince Nov 1, 2012 Accepting new patients
The Heart Institute of Venice PLLC CurrentSince Nov 21, 2024 Accepting new patients
Sterling Emergency Services of Miami Beach PA Emergency Medicine CurrentSince Nov 1, 2012 Accepting new patients
Inphynet South Broward LLC Emergency Medicine CurrentSince Feb 1, 2012 Accepting new patients
Ortho Florida, LLC CurrentSince Nov 1, 2015 Accepting new patients
Ortho Florida, LLC CurrentSince Nov 1, 2015 Accepting new patients

Locations

660 Glades Rd
Ste 460
Boca Raton, FL 33431
Phone (561) 300-1792

1601 Clint Moore Rd
Ste 125
Boca Raton, FL 33487
Phone (561) 395-5733

11050 Griffin Rd
Ste 104
Davie, FL 33328
Phone (954) 442-7616

11050 Griffin Rd
Davie, FL 33328
Phone (786) 627-5162

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

2845 NE 199th St
Miami, FL 33180
Phone (305) 692-1000

703 N Flamingo Rd
Pembroke Pnes, FL 33028
Phone (954) 436-5000

5966 S Dixie Hwy
Ste 401
South Miami, FL 33143
Phone (786) 453-2667

1370 E Venice Ave
Ste 102
Venice, FL 34285

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

Organizations & group practices 6

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": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1083851356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5966 S DIXIE HWY STE 401",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435177",
            "telephone_number": "786-453-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5966 S DIXIE HWY STE 401",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435177",
            "telephone_number": "786-453-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSELLI",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-08",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME111396",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "252635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.