Individual provider Active NPI

Bisma Gowani, DPM

  • Foot & Ankle Surgery Podiatrist
  • Hollywood, FL
National Provider Identifier
1487214888
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO4359 Issued in FL
Practice address
9950 Stirling Rd Ste 108
Hollywood, FL 33024-8001
Phone
(407) 463-8621
NPI assigned
Jun 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Public Medicine PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213EP0504X E5991 CA
Primary Podiatric Medicine Podiatrist 213EP1101X E5991 CA
Foot & Ankle Surgery Podiatrist 213ES0103X PO4359 FL Primary

Addresses

Primary practice location

9950 Stirling Rd Ste 108
Hollywood, FL 33024-8001

Mailing address

8721 Lake Tibet CT
Orlando, FL 32836-5481
Phone (407) 463-8621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220930001485 FL Practitioner - Podiatry 2365828118 Reassigns benefits to 1 organization
I20230811002347 CA Practitioner - Podiatry 2365828118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1846 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5545

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue69
Removal or shaving of skin growth49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5991CAMDPublic Medicine Podiatrist
5991CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Apr 15, 2024 Accepting new patients
Family Health Centers of San Diego, Inc Multi-Specialty Current Accepting new patients
Podiatry Health Services LLC Multi-Specialty CurrentSince Oct 1, 2024 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Apr 15, 2024 Accepting new patients

Locations

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

9950 Stirling Rd
Ste 108
Hollywood, FL 33024
Phone (954) 704-1828

1846 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (516) 446-6448

Organizations & group practices 4

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": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1487214888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8721 LAKE TIBET CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328365481",
            "telephone_number": "407-463-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9950 STIRLING RD STE 108",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330248001",
            "telephone_number": "407-463-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWANI",
        "first_name": "BISMA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP0504X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Public Medicine",
            "state": "CA",
            "license": "E5991",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E5991",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO4359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.