Marvin Khalid Smith, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

ME136735 Issued in FL

Practice address

1150 N 35TH Ave Ste 130
Hollywood, FL 33021

Phone

(954) 265-7700

Fax

(954) 893-3799

NPI assigned

Apr 12, 2012

Last updated

Mar 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Orthopedic Surgery

Education

University of Miami, LM Miller School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038
• Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msmith194750@mhsdirect.net

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.

• South Broward Hospital District

  dba Memorial Division of Orthopaedic Surgery and Sports Medicine

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Hollywood, FL
  • NPI 1174942783
  Medicare reassignment Care Compare group NPD
• South Broward Hospital District

  dba Memorial Home Infusion

  • Home Infusion Therapy Pharmacy
  • Miramar, FL
  • NPI 1043656614
  NPD
• South Broward Hospital District

  dba Memorial Division of Pediatric Specialty

  • Pediatric Hematology & Oncology Physician
  • Hollywood, FL
  • NPI 1639187180
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Broward Hospital District

  dba Memorial Hospital West

  • General Acute Care Hospital
  • Pembroke Pines, FL
  • NPI 1134102080
  Care Compare affiliation
• South Broward Hospital District

  dba Memorial Regional Hospital

  • General Acute Care Hospital
  • Hollywood, FL
  • NPI 1780667923
  Care Compare affiliation

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1538426820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE STE 130",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-265-7700",
            "fax_number": "954-893-3799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3702 Washington St Ste 303",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330218287",
            "country_code": "US",
            "telephone_number": "954-265-8326",
            "fax_number": "954-893-3799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2122 W Cypress Creek Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Ft Lauderdale",
            "state": "FL",
            "postal_code": "333091868",
            "country_code": "US",
            "telephone_number": "954-265-7700",
            "fax_number": "954-276-0435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARVIN",
        "middle_name": "KHALID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME136735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msmith194750@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1150 N 35th Ave Ste 130",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Iesha Smith
• Janelle Smith, PHARMD
• Jasmyn Smith, RBT
• Julia Smith, CAA
• Latesha Evyette Smith, RN
• Michelle Sofia Smith, MD
• Peter Lloyd Smith II, MS PT
• Rachel A Smith, MS, LMFT
• Robert Terry Smith, MEDICAL DOCTOR
• Ronald D Smith, MD

• Sports Medicine (Orthopaedic Surgery) Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.