NPIMap

Organization Active NPI

Orthopaedic Medical Group of Tampa Bay PA

  • Orthopaedic Surgery Physician
  • Sun City Center, FL
National Provider Identifier
1669124665
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPAEDIC MEDICAL GROUP OF TAMPA BAY PA
Practice address
1901 Haverford Ave Ste 107108
Sun City Center, FL 33573-5200
Phone
(813) 684-2663
Fax
(813) 658-6222
NPI assigned
Jan 20, 2022
Organization subpart
Yes
Parent organization
ORTHOPAEDIC MEDICAL GROUP OF TAMPA BAYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Scott Goldsmith, MD
Title
President
Phone
(813) 684-2663

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X

Addresses

Primary practice location

1901 Haverford Ave Ste 107108
Sun City Center, FL 33573-5200

Mailing address

PO Box 850001 Dept 8272
Orlando, FL 32885-8272
Phone (813) 684-2663

Other identifiers 1

IdentifierTypeStateIssuer
122422100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240807000046 FL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 9436220415 Practice locations: Sun City Center, FL

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Orthopaedic Medical Gro10 organizations share this tax ID, including this one
Part of
Orthopaedic Medical Gro

Other organizations with this tax ID 9

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CGCJBD

NPI Registry JSON

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1669124665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001 DEPT 8272",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328858272",
            "telephone_number": "813-684-2663",
            "fax_number": "813-658-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 HAVERFORD AVE STE 107108",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335735200",
            "telephone_number": "813-684-2663",
            "fax_number": "813-658-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC MEDICAL GROUP OF TAMPA BAY PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHOPAEDIC MEDICAL GROUP OF TAMPA BAY",
        "enumeration_date": "2022-01-20",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "GOLDSMITH",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-684-2663",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122422100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City Center, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.