Individual provider Active NPI

Mark Abraham Sukenik, M.D.

  • Otolaryngology Physician
  • Hollywood, FL
National Provider Identifier
1528069242
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME75107 Issued in FL
Practice address
4700 Sheridan St
Suite K
Hollywood, FL 33021-3420
Phone
(954) 966-7000
Fax
(954) 966-7095
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME75107 FL Primary

Addresses

Primary practice location

4700 Sheridan St
Suite K
Hollywood, FL 33021-3420

Mailing address

15280 NW 79TH CT Ste 200
Miami Lakes, FL 33016-5873
Phone (305) 558-3724

Other identifiers 1

IdentifierTypeStateIssuer
266656100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marksukenik@sfa.allscriptsdirect.net South Florida ENT Associates, Inc.

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
I20050131000286 FL Practitioner - OtolaryngologyPractitioner - Anesthesiology 4284684945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Emory University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida ENT Associates IncGroup PAC ID 4587556923, 156 clinicians

Practice addresses (Care Compare)

4700 Sheridan St
Hollywood, FL 33021-3416
Phone (954) 966-7000

Hospital & facility affiliations

  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida ENT Associates, Inc. Otolaryngology CurrentSince Jan 1, 2005 Accepting new patients

Locations

7900 Glades Rd
Ste 340
Boca Raton, FL 33434
Phone (561) 353-7377

4700 Sheridan St
Ste K
Hollywood, FL 33021
Phone (954) 962-0040

5012 Hollywood Blvd
Hollywood, FL 33021
Phone (954) 966-7000

8940 N Kendall Dr
Ste 504E
Miami, FL 33176
Phone (305) 595-6200

15280 NW 79th Ct
Ste 200
Miami Lakes, FL 33016

8181 NW 154th St
Ste 200
Miami Lakes, FL 33016
Phone (225) 298-3537

18501 Pines Blvd
Ste 210
Pembroke Pines, FL 33029
Phone (954) 237-2505

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.

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": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1528069242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15280 NW 79TH CT STE 200",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165873",
            "telephone_number": "305-558-3724",
            "fax_number": "786-907-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SHERIDAN ST",
            "address_2": "SUITE K",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213420",
            "telephone_number": "954-966-7000",
            "fax_number": "954-966-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUKENIK",
        "first_name": "MARK",
        "middle_name": "ABRAHAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME75107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266656100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marksukenik@sfa.allscriptsdirect.net",
            "affiliation": "Y",
            "affiliationName": "South Florida ENT Associates, Inc.",
            "address_1": "4700 Sheridan St",
            "address_2": "SUITE K",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330213420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.