Active NPI
Samuel Paul Popinchalk, M.D.
- Orthopaedic Surgery of the Spine Physician
- Aventura, FL
National Provider Identifier
1306072129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery of the Spine Physician
- License
- ME125095
- Practice address
- 21097 NE 27TH CT
Suite 540
Aventura, FL 33180-1204 - Phone
- (786) 623-2000
- Fax
- (786) 221-4276
- NPI assigned
- Jun 8, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MT195641 | PA | |
| Orthopaedic Surgery Physician | 207X00000X | ME125095 | FL | |
| Orthopaedic Surgery of the Spine Physician | 207XS0117X | ME125095 | FL | Primary |
Addresses
Primary practice location
21097 NE 27TH CT
Suite 540
Aventura, FL 33180-1204
Mailing address
21097 NE 27TH CT
Suite 540
Aventura, FL 33180-1204
Phone (786) 623-2000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME125095 | Other | FL | FLORIDA STATE BOARD OF MEDICINE |
| MT195641 | Other | PA | PENNSYLVANIA STATE MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME125095 | FL | MD | Orthopaedic Surgery Physician |
| MT195641 | PA | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484265600000",
"number": "1306072129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21097 NE 27TH CT",
"address_2": "SUITE 540",
"city": "AVENTURA",
"state": "FL",
"postal_code": "331801204",
"telephone_number": "786-623-2000",
"fax_number": "786-221-4276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21097 NE 27TH CT",
"address_2": "SUITE 540",
"city": "AVENTURA",
"state": "FL",
"postal_code": "331801204",
"telephone_number": "786-623-2000",
"fax_number": "786-221-4276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPINCHALK",
"first_name": "SAMUEL",
"middle_name": "PAUL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-08",
"last_updated": "2017-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "PA",
"license": "MT195641",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "FL",
"license": "ME125095",
"primary": false
},
{
"code": "207XS0117X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
"state": "FL",
"license": "ME125095",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA STATE BOARD OF MEDICINE",
"identifier": "ME125095",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PENNSYLVANIA STATE MEDICAL LICENSE",
"identifier": "MT195641",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aventura, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.