Rafael Segundo Briceno, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME97155 Issued in FL

Practice address

3363 Sheridan St
Suite 207
Hollywood, FL 33021-3664

Phone

(954) 964-2450

Fax

(954) 964-6084

NPI assigned

Jan 4, 2007

Last updated

Jul 8, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Specialty

Family Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sawgrass Hospitalist PAGroup PAC ID 3577709278, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
• Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285
• Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sawgrass Hospitalist PA

  • Hospitalist Physician
  • Hollywood, FL
  • NPI 1447595194
  Medicare reassignment Care Compare group NPD Authorized official
• South Broward Hospital District

  dba Memorial Division of Critical Care

  • Critical Care Medicine (Internal Medicine) Physician
  • Hollywood, FL
  • NPI 1609884154
  Medicare reassignment NPD
• South Broward Hospital District

  dba Memorial Home Infusion

  • Home Infusion Therapy Pharmacy
  • Miramar, FL
  • NPI 1043656614
  NPD
• South Broward Hospital District

  dba Memorial House Staff Physicians

  • Specialist
  • Hollywood, FL
  • NPI 1407897960
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Broward Hospital District

  dba Memorial Hospital West

  • General Acute Care Hospital
  • Pembroke Pines, FL
  • NPI 1134102080
  Care Compare affiliation
• South Broward Hospital District

  dba Memorial Hospital Miramar

  • General Acute Care Hospital
  • Miramar, FL
  • NPI 1326021197
  Care Compare affiliation
• South Broward Hospital District

  dba Memorial Regional Hospital

  • General Acute Care Hospital
  • Hollywood, FL
  • NPI 1780667923
  Care Compare affiliation

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1174670863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 816759",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330810759",
            "telephone_number": "954-964-2450",
            "fax_number": "954-964-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3363 SHERIDAN ST",
            "address_2": "SUITE 207",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213664",
            "telephone_number": "954-964-2450",
            "fax_number": "954-964-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICENO",
        "first_name": "RAFAEL",
        "middle_name": "SEGUNDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD29002",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A97677",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME97155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003117000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "14P2T",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juan Carlos Brenes, M.D.
• Rita Brennan, B.A.
• Brentwood Medical Supplies LLC
• Rosalyn Brewer, M.D./PH.D.
• Brian B Ibrahim MD PA
• Gloria D Brickenden, M.A., OTR/L
• Bridge Disability Network, Inc.
• Bridge of Help Services
• Mark Wilson Bridges, M.D.
• Alexandra Fay Brier

• Family Medicine Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.

Verify at the official NPI Registry.