Organization Active NPI

Cynthia H Halcin MD PA

  • Specialist
  • Rockledge, FL
National Provider Identifier
1578701785
Registry record updated Apr 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME73166 Issued in FL
Legal business name
CYNTHIA H HALCIN MD PA
Practice address
830 Executive Lane
Suite 110
Rockledge, FL 32955-3595
Phone
(321) 394-8000
Fax
(321) 394-8002
NPI assigned
Jan 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2009

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

Authorized official

Name
Cynthia H Halcin, MDNPI 1942270988
Title
MD/Owner
Phone
(321) 394-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X ME73166 FL Primary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X ME73166 FL

Addresses

Primary practice location

830 Executive Lane
Suite 110
Rockledge, FL 32955-3595

Mailing address

830 Executive Lane
Suite 110
Rockledge, FL 32955-3595
Phone (321) 394-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090408000088 FL Part B Supplier - Clinic/Group Practice 1951458017 Receives reassigned benefits from 2 practitioners
Practice locations: Rockledge, FL

National Provider Directory

National Provider Directory

Locations

830 Executive Ln
Ste 110
Rockledge, FL 32955
Phone (321) 394-8000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239926400000",
    "number": "1578701785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 EXECUTIVE LANE",
            "address_2": "SUITE 110",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553595",
            "telephone_number": "321-394-8000",
            "fax_number": "321-394-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 EXECUTIVE LANE",
            "address_2": "SUITE 110",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553595",
            "telephone_number": "321-394-8000",
            "fax_number": "321-394-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYNTHIA H HALCIN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-04-17",
        "status": "A",
        "authorized_official_last_name": "HALCIN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "321-394-8000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME73166",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME73166",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.