NPIMap

Organization Active NPI

South Florida Orthopaedics & Sports Medicine,PA

  • Durable Medical Equipment & Medical Supplies
  • Stuart, FL
National Provider Identifier
1639220700
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SOUTH FLORIDA ORTHOPAEDICS & SPORTS MEDICINE,PA
Practice address
1050 SE Monterey Rd Ste 102
Stuart, FL 34994-4512
Phone
(772) 223-8816
Fax
(772) 781-7375
NPI assigned
Jan 16, 2007
Last updated
Oct 26, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Authorized official

Name
Dr. William E. Carlson, M.D.NPI 1558344630
Title
Managing Partner
Phone
(772) 288-2400

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

1050 SE Monterey Rd Ste 102
Stuart, FL 34994-4512

Mailing address

1050 SE Monterey Rd
Suite 400
Stuart, FL 34994-4512
Phone (772) 288-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930082479 FL DME Supplier - Physician - Podiatry 6406838895 Practice locations: Stuart, FL

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Scott M Desman MD10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 118

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 118

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603670400000",
    "number": "1639220700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SE MONTEREY RD",
            "address_2": "SUITE 400",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-288-2400",
            "fax_number": "772-419-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 SE MONTEREY RD STE 102",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-223-8816",
            "fax_number": "772-781-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA ORTHOPAEDICS & SPORTS MEDICINE,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "772-288-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.