Individual provider Active NPI

Antonio Roki, MD

  • Surgery Physician
  • Ft Lauderdale, FL
National Provider Identifier
1548835176
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
162854 Issued in FL
Practice address
4725 N Federal Hwy
Ft Lauderdale, FL 33308-4668
Phone
(954) 938-3359
Fax
(954) 492-5790
NPI assigned
May 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 162854 FL Primary

Addresses

Primary practice location

4725 N Federal Hwy
Ft Lauderdale, FL 33308-4668

Mailing address

4725 N Federal Hwy
Ft Lauderdale, FL 33308-4668
Phone (954) 938-3359

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
I20231110000086 FL Practitioner - General Surgery 6507266970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
162854FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Wound Care of Florida LLC CurrentSince Sep 25, 2023 Accepting new patients

Locations

3648 University Blvd S
Jacksonville, FL 32216
Phone (904) 345-7185

1481 McDonald Ave
Brooklyn, NY 11230
Phone (347) 479-1110

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": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1548835176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4725 N FEDERAL HWY",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084668",
            "telephone_number": "954-938-3359",
            "fax_number": "954-492-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 N FEDERAL HWY",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084668",
            "telephone_number": "954-938-3359",
            "fax_number": "954-492-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROKI",
        "first_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-25",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "162854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.