Organization Active NPI

Robert C Siudmak & Associates MD PA

  • Obstetrics & Gynecology Physician
  • Hollywood, FL
National Provider Identifier
1669495842
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME40226 Issued in FL
Legal business name
ROBERT C SIUDMAK & ASSOCIATES MD PA
Practice address
3801 Hollywood Blvd
Suite 250
Hollywood, FL 33021-6758
Phone
(954) 961-8303
Fax
(954) 961-8307
NPI assigned
Jul 26, 2006
Last updated
May 21, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Authorized official

Name
Dr. Robert C Siudmak, M.D.NPI 1073792180
Title
President
Phone
(954) 961-8303

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
Obstetrics & Gynecology Physician 207V00000X ME40226 FL Primary

Addresses

Primary practice location

3801 Hollywood Blvd
Suite 250
Hollywood, FL 33021-6758

Mailing address

3801 Hollywood Blvd
Suite 250
Hollywood, FL 33021-6758
Phone (954) 961-8303

Other identifiers 1

IdentifierTypeStateIssuer
067037500MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120125000449 FL Part B Supplier - Clinic/Group Practice 8527235951 Receives reassigned benefits from 2 practitioners
Practice locations: Hollywood, FL; Pembroke Pines, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0277931Robert C Siudmak & Associates MD PA3801 Hollywood Blvd Suite 250, Hollywood, FL 33021Provider-performed microscopyJan 2, 2028

National Provider Directory

National Provider Directory

Locations

3801 Hollywood Blvd
Ste 250
Hollywood, FL 33021
Phone (954) 961-8303

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369094400000",
    "number": "1669495842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 HOLLYWOOD BLVD",
            "address_2": "SUITE 250",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216758",
            "telephone_number": "954-961-8303",
            "fax_number": "954-961-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 HOLLYWOOD BLVD",
            "address_2": "SUITE 250",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216758",
            "telephone_number": "954-961-8303",
            "fax_number": "954-961-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT C SIUDMAK & ASSOCIATES MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2013-05-21",
        "status": "A",
        "authorized_official_last_name": "SIUDMAK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-961-8303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME40226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067037500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.