Individual provider Active NPI

Daniel R Dziadosz, MD

  • Orthopaedic Trauma Physician
  • St Petersburg, FL
National Provider Identifier
1609015452
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
ME103748 Issued in FL
Practice address
603 7TH St S Ste 100
St Petersburg, FL 33701-4719
Phone
(727) 553-7431
Fax
(727) 553-7432
NPI assigned
Feb 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 302025 NY
Orthopaedic Trauma Physician 207XX0801X 302025 NY
Orthopaedic Trauma Physician 207XX0801X ME103748 FL Primary

Addresses

Primary practice location

603 7TH St S Ste 100
St Petersburg, FL 33701-4719

Mailing address

603 7TH St S Ste 100
St Petersburg, FL 33701-4719
Phone (727) 553-7431

Other practice location 1

520 East 70th Street
Starr2
New York, NY 10021-9800
Phone (646) 962-2904

Other identifiers 6

IdentifierTypeStateIssuer
328012OtherFLAVMED
003162720AMedicaidGA
018363000MedicaidFL
1186918OtherFLCIGNA
14515OtherFLBCBS
9262296OtherFLAETNA

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ddziadosz116507@direct.HSS.edu Direct
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Direct
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/ Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY, NJ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20090721000634 FL Practitioner - Orthopedic Surgery 2769534866 Reassigns benefits to 2 organizations
I20200205002371 NY Practitioner - Orthopedic Surgery 2769534866 Reassigns benefits to 1 organization
I20231130003749 NJ Practitioner - Orthopedic Surgery 2769534866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

701 6TH St S
St Petersburg, FL 33701-4814
Phone (727) 823-1234

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.63 of 100Reported as apm
Quality
81.86
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME103748FLMDOrthopaedic Trauma Physician
302025NYMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohi West Medical Group, LLC CurrentSince Sep 1, 2024 Accepting new patients
Health First Medical Group, LLC CurrentSince Jul 7, 2021 Accepting new patients
Ohi West Medical Group, LLC Current Accepting new patients
Ny Society for the Relief of Ruptured & Crippled Maintaining Orthopaedic Surgery CurrentSince Feb 1, 2020 Accepting new patients
Health First Physician Specialties Inc Orthopaedic Trauma CurrentSince Jul 7, 2021 Accepting new patients
Ohi West Medical Group, LLC CurrentSince Sep 1, 2024 Accepting new patients
Barnabas Health Medical Group PC Orthopaedic Surgery CurrentSince Nov 27, 2023 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Nov 27, 2023 Accepting new patients
Health First Medical Group, LLC Orthopaedic Surgery CurrentSince Jul 7, 2021 Accepting new patients
Ny Society for the Relief of Ruptured & Crippled Maintaining Orthopaedic Surgery CurrentSince Feb 1, 2020 Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients
Musculoskeletal Institute Chartered Orthopaedic Surgery Past Accepting new patients

Locations

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

1350 Hickory St
Ste 101
Melbourne, FL 32901
Phone (321) 434-1401

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

603 7th St S
Ste 100
St Petersburg, FL 33701
Phone (727) 553-7240

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

725 6th Ave S
Ste 3200
St Petersburg, FL 33701
Phone (561) 667-2030

603 7th St S
Ste 450
St Petersburg, FL 33701
Phone (727) 822-6666

100 Town Square Pl
Ste 208
Jersey City, NJ 07310
Phone (201) 716-5850

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

200 S Orange Ave
Ste 230
Livingston, NJ 07039
Phone (973) 322-7005

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

535 E 70th St
New York, NY 10021

520 E 70th St
#2
New York, NY 10021
Phone (646) 962-2904

520 E 70th St
New York, NY 10021
Phone (212) 746-0838

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
  • Direct secure messaging: ddziadosz116507@direct.hss.edu
  • Direct secure messaging: ddziadosz71487@epicdirect.hf.org
  • Direct secure messaging: ddziadosz50066@lrhs.direct-ci.com
  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 12

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 2

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": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1609015452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 7TH ST S STE 100",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014719",
            "telephone_number": "727-553-7431",
            "fax_number": "727-553-7432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 7TH ST S STE 100",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014719",
            "telephone_number": "727-553-7431",
            "fax_number": "727-553-7432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 East 70th Street",
            "address_2": "Starr2",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100219800",
            "country_code": "US",
            "telephone_number": "646-962-2904",
            "fax_number": "646-962-0845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DZIADOSZ",
        "first_name": "DANIEL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-18",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "302025",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "NY",
            "license": "302025",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "FL",
            "license": "ME103748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "328012",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003162720A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018363000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1186918",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14515",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9262296",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddziadosz116507@direct.HSS.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "520 East 70th Street",
            "address_2": "Starr2",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100219800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "520 East 70th Street",
            "address_2": "Starr2",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100219800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "520 East 70th Street",
            "address_2": "Starr2",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100219800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.