Individual provider Active NPI

Igor Nichiporenko, M.D.

  • Surgery Physician
  • Deerfield Beach, FL
National Provider Identifier
1700104874
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME 107033 Issued in FL
Practice address
201 E Sample Rd
Deerfield Beach, FL 33064-3502
Phone
(954) 941-8300
NPI assigned
May 13, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X ME107033 FL
Specialist 174400000X ME107033 FL
Surgery Physician 208600000X ME 107033 FL Primary

Addresses

Primary practice location

201 E Sample Rd
Deerfield Beach, FL 33064-3502

Mailing address

2006 NE 49TH St
Fort Lauderdale, FL 33308-4524
Phone (954) 210-4120

Other practice location 1

5352 Linton Blvd
Delray Beach, FL 33484-6514
Phone (561) 498-4440

Other practice location 2

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
Phone (954) 355-4400

Other identifiers 1

IdentifierTypeStateIssuer
004456500MedicaidFL

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110901000295 FL Practitioner - General Surgery 3072783950 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Delray Trauma Associates, LLCGroup PAC ID 0042457038, 9 clinicians

Practice addresses (Care Compare)

1600 S Andrews Ave
Broward Health Medical Center
Fort Lauderdale, FL 33316-2510
Phone (954) 491-0900

Hospital & facility affiliations

  • Broward Health Medical Center Hospital, Fort Lauderdale, FL, CCN 100039

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 107033FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trauma and Critical Care Associates, LLC Surgery CurrentSince Apr 13, 2021 Accepting new patients
Delray Trauma Associates, LLC Specialist CurrentSince May 12, 2020 Accepting new patients

Locations

201 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 786-6400

5352 Linton Blvd
Delray Beach, FL 33484
Phone (561) 495-3166

2006 NE 49th St
Ft Lauderdale, FL 33308
Phone (954) 210-4120

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

2800 E Commercial Blvd
Ste 102
Ft Lauderdale, FL 33308
Phone (954) 491-0900

Organizations & group practices 2

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 1

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": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1700104874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 NE 49TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084524",
            "telephone_number": "954-210-4120",
            "fax_number": "954-958-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E SAMPLE RD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330643502",
            "telephone_number": "954-941-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5352 Linton Blvd",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334846514",
            "country_code": "US",
            "telephone_number": "561-498-4440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 S Andrews Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333162510",
            "country_code": "US",
            "telephone_number": "954-355-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHIPORENKO",
        "first_name": "IGOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-13",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "FL",
            "license": "ME107033",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME107033",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME 107033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004456500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.