Individual provider Active NPI

Susana Barros-Sierra, MD

  • Family Medicine Physician
  • Hollywood, FL
National Provider Identifier
1295354744
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME164893 Issued in FL
Practice address
5010 Hollywood Blvd Ste 100B
Hollywood, FL 33021-6557
Phone
(954) 266-2999
Fax
(954) 966-3320
NPI assigned
Apr 14, 2020
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X ME164893 FL Primary

Addresses

Primary practice location

5010 Hollywood Blvd Ste 100B
Hollywood, FL 33021-6557

Mailing address

3622 Coral Way Apt 607
Miami, FL 33145-3285
Phone (631) 428-7361

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
I20231020002635 FL Practitioner - Family Practice 2163878588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5010 - 5012 Hollywood Blvd
Hollywood, FL 33021-6557

5010 Hollywood Blvd
Hollywood, FL 33021-6557
Phone (954) 967-0028

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME164893FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Broward Community and Family Health Centers Inc Current Accepting new patients
Broward Community and Family Health Centers Inc CurrentSince Oct 16, 2023 Accepting new patients
Broward Community and Family Health Centers Inc CurrentSince Oct 16, 2023 Accepting new patients

Locations

5010 Hollywood Blvd
Hollywood, FL 33021

5010 Hollywood Blvd
Ste 100B
Hollywood, FL 33021
Phone (954) 967-0028

1295 NW 40th Ave
#200
Lauderhill, FL 33313
Phone (954) 583-4710

168 N Powerline Rd
Pompano Beach, FL 33069
Phone (954) 633-0023

5800 W Hallandale Beach Blvd
West Park, FL 33023
Phone (954) 966-3939

Organizations & group practices 3

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.

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": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1295354744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3622 CORAL WAY APT 607",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331453285",
            "telephone_number": "631-428-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 HOLLYWOOD BLVD STE 100B",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216557",
            "telephone_number": "954-266-2999",
            "fax_number": "954-966-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARROS-SIERRA",
        "first_name": "SUSANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME164893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.