NPIMap

Organization Active NPI

Orthopaedic Medical Group of Tampa Bay PA

  • Orthopaedic Surgery Physician
  • Winter Haven, FL
National Provider Identifier
1225414469
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPAEDIC MEDICAL GROUP OF TAMPA BAY PA
Practice address
400 Avenue K SE Ste 4
Winter Haven, FL 33880-4123
Phone
(813) 684-2663
Fax
(813) 658-6222
NPI assigned
Aug 10, 2015
Last updated
Oct 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Scott Goldsmith, MDNPI 1619166261
Title
President
Phone
(813) 684-2663

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

400 Avenue K SE Ste 4
Winter Haven, FL 33880-4123

Mailing address

PO Box 850001 Dept 8272
Orlando, FL 32885-8272
Phone (813) 684-2263

Other identifiers 1

IdentifierTypeStateIssuer
122422100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160215002690 FL DME Supplier - Physician - General Practice 9436220415 Practice locations: Winter Haven, FL

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Orthopaedic Medical Gro10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7239 Paradiso Dr
Apollo Beach, FL 33572

13837 Circa Crossing Dr
Ste 110
Lithia, FL 33547
Phone (813) 534-0102

414 N Plant Ave
Plant City, FL 33563
Phone (813) 478-9665

6901 Simmons Loop
#201
Riverview, FL 33578

2805 54th Ave N
St Petersburg, FL 33714
Phone (727) 613-1749

1901 Haverford Ave
Ste 107108
Sun City Center, FL 33573

10740 Palm River Rd
Ste 310
Tampa, FL 33619
Phone (813) 590-0553

1155 S Dale Mabry Hwy
Ste 8
Tampa, FL 33629
Phone (813) 207-5027

4541 S Dale Mabry Hwy
Fl 2
Tampa, FL 33611
Phone (813) 877-3059

4541 S Dale Mabry Hwy
Ste 200
Tampa, FL 33611

2553 Windguard Cir
Wesley Chapel, FL 33544
Phone (813) 388-6827

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1225414469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001 DEPT 8272",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328858272",
            "telephone_number": "813-684-2263",
            "fax_number": "813-441-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AVENUE K SE STE 4",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804123",
            "telephone_number": "813-684-2663",
            "fax_number": "813-658-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC MEDICAL GROUP OF TAMPA BAY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-10",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "GOLDSMITH",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-684-2663",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122422100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.