Individual provider Active NPI

Roni Komie, L.C.S.W.

  • Clinical Social Worker
  • Hollywood, FL
National Provider Identifier
1326419573
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW2806 Issued in FL
Practice address
2751 S Ocean Dr
#1803-S
Hollywood, FL 33019-2721
Phone
(954) 929-5797
NPI assigned
Oct 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW2806 FL Primary

Addresses

Primary practice location

2751 S Ocean Dr
#1803-S
Hollywood, FL 33019-2721

Mailing address

2751 S Ocean Dr
#1803-S
Hollywood, FL 33019-2721
Phone (954) 929-5797

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151211000247 FL Practitioner - Clinical Social Worker 6002117363 Practice locations: Hollywood, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1600 Taft St
Hollywood, FL 33020-3272
Phone (954) 923-5057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW2806FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Roni Komie Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1326419573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 S OCEAN DR",
            "address_2": "#1803-S",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192721",
            "telephone_number": "954-929-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 S OCEAN DR",
            "address_2": "#1803-S",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192721",
            "telephone_number": "954-929-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMIE",
        "first_name": "RONI",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW2806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.