Individual provider Active NPI

Wayne Peter Digiacomo, MD

  • Obstetrics & Gynecology Physician
  • Hallandale Beach, FL
National Provider Identifier
1346205812
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME0034571 Issued in FL
Practice address
3001 W Hallandale Beach Blvd
Suite 200
Hallandale Beach, FL 33009-5155
Phone
(954) 456-4888
Fax
(954) 456-9721
NPI assigned
Apr 19, 2006
Last updated
Sep 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME0034571 FL Primary

Addresses

Primary practice location

3001 W Hallandale Beach Blvd
Suite 200
Hallandale Beach, FL 33009-5155

Mailing address

3001 W Hallandale Beach Blvd
Suite 200
Hallandale Beach, FL 33009-5155
Phone (954) 456-4888

Other identifiers 2

IdentifierTypeStateIssuer
065501599MedicaidFL
ME0034571OtherFLSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031204000766 FL Practitioner - Obstetrics/Gynecology 5991600785 Reassigns benefits to 1 organization
I20200320002220 GA Practitioner - Obstetrics/Gynecology 5991600785 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0034571FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Jun 16, 2019 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology Current Accepting new patients
Obhg Georgia, P.C. Obstetrics & Gynecology CurrentSince Jan 7, 2020 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Jun 16, 2019 Accepting new patients
Surg Med Assistants Past Accepting new patients
Surg Med of Northshore Past Accepting new patients
Venetian Isle Medical OB GYN Consultant Inc Past Accepting new patients
C & H Medical Corp. Past Accepting new patients

Locations

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

1900 Tebeau St
Waycross, GA 31501
Phone (912) 283-3030

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 576-8798

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1346205812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 W HALLANDALE BEACH BLVD",
            "address_2": "SUITE 200",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330095155",
            "telephone_number": "954-456-4888",
            "fax_number": "954-456-9721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 W HALLANDALE BEACH BLVD",
            "address_2": "SUITE 200",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330095155",
            "telephone_number": "954-456-4888",
            "fax_number": "954-456-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGIACOMO",
        "first_name": "WAYNE",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME0034571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065501599",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME0034571",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

Verify at the official NPI Registry.