Sepideh Sepiddam

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11025664 Issued in FL

Practice address

3800 S Ocean Dr Ste 209
Hollywood, FL 33019-2915

Phone

(800) 226-8874

NPI assigned

Mar 31, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Theo Medical Dermatology LLCGroup PAC ID 4688814999, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00298

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.

• Theo Medical Dermatology, LLC

  • Dermatology Physician
  • Apopka, FL
  • NPI 1558707588
  Medicare reassignment Care Compare group NPD
• Quality Surgical Management Inc

  • Surgery Physician
  • Hollywood, FL
  • NPI 1376758904
  Medicare reassignment NPD
• Shawnee Mission Medical Center Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Merriam, KS
  • NPI 1992735690
  NPD (past)

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1649975574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 S OCEAN DR STE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192915",
            "telephone_number": "800-226-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S OCEAN DR STE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192915",
            "telephone_number": "800-226-8874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "604 Trelago Way Apt 111",
            "address_purpose": "LOCATION",
            "city": "Maitland",
            "state": "FL",
            "postal_code": "327514380",
            "country_code": "US",
            "telephone_number": "407-779-4963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEPIDDAM",
        "first_name": "SEPIDEH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-31",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11025664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Senior Medical Associates LLC
• Senior Medical Care I LLC
• Senior Services Group Inc.
• Senior Support Services, Inc.
• Michelle M Senko
• Iliana Sepulveda-Romero, MA
• Sandra Sepulveda, APRN
• Nathalie Seraphin
• Samuel Sered, M.D.
• Serene and Fearless Counseling Services LLC

• Family Nurse Practitioner in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.