Wilson Dumornay, M.D.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

ME96799 Issued in FL

Practice address

4101 S. Hospital Drive
Suite 14
Plantation, FL 33317-2857

Phone

(954) 368-3348

Fax

(954) 900-4720

NPI assigned

Oct 10, 2006

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

Otolaryngology

Education

Temple University School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Florida Surgical Specialists LLCGroup PAC ID 5799881660, 91 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Broward Health Medical Center Hospital, Fort Lauderdale, FL, CCN 100039
• Broward Health North Hospital, Deerfield Beach, FL, CCN 100086

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• South Florida Surgical Specialists LLC

  • Surgery Physician
  • Coral Springs, FL
  • NPI 1952409963
  Medicare reassignment Care Compare group NPD
• ENT Associates of Broward LLC

  • Facial Plastic Surgery Physician
  • Coral Springs, FL
  • NPI 1730337098
  NPD (past)
• Douglas Family Medicine Assoc

  • Family Medicine Physician
  • Douglas, GA
  • NPI 1508915687
  NPD (past)
• Westside Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Douglas, GA
  • NPI 1013158948

  Otolaryngology

  NPD (past)

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

• North Broward Hospital District

  • General Acute Care Hospital
  • Fort Lauderdale, FL
  • NPI 1285662239
  Care Compare affiliation
• North Broward Hospital District

  • General Acute Care Hospital
  • Pompano Beach, FL
  • NPI 1376571323
  Care Compare affiliation
• North Broward Hospital District

  • Emergency Care Clinic/Center
  • Lighthouse Point, FL
  • NPI 1720936792

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1245327246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 S. HOSPITAL DRIVE",
            "address_2": "SUITE 14",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172857",
            "telephone_number": "954-368-3348",
            "fax_number": "954-900-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 S. HOSPITAL DRIVE",
            "address_2": "SUITE 14",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172857",
            "telephone_number": "954-368-3348",
            "fax_number": "954-900-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMORNAY",
        "first_name": "WILSON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "68723",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "FL",
            "license": "ME96799",
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "68723",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA MEDICAL LICENSE",
            "identifier": "68723",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICAL LICENSE",
            "identifier": "ME 96799",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fabiola Duarte, DDS
• Chirag Dubal, PHARM. D.
• Marianne Dubin I, L.C.S.W.
• Yevgeniya Dubrovskaya, M.D.
• Ritchelle Martinez Dubrovskiy, D.O.
• Dunamis Health Care Corp
• Dunamis Medical LLC
• Marc Dunevant, PHARMD
• Joanna Antoinette Dunk, ARNP
• Arleen Dunkley-Evans, MD, FAAP

• Facial Plastic Surgery Physician in Plantation, FL
• Providers in Plantation, FL by specialty
• Facial Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.