Individual provider Active NPI

Maurice Winnick, DO

  • Anesthesiology Physician
  • Port Saint Lucie, FL
National Provider Identifier
1700824067
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OS8276 Issued in FL
Practice address
1874 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5545
Phone
(772) 337-7676
Fax
(772) 337-9034
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X OS8276 FL Primary

Addresses

Primary practice location

1874 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5545

Mailing address

2695 SW Bear Paw TRL
Palm City, FL 34990-7940

Other identifiers 2

IdentifierTypeStateIssuer
268945600MedicaidFL
37594OtherFLBCBS OF FLORIDA

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
I20040504001031 FL Practitioner - Anesthesiology 3779571146 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centurion Anesthesia - FL LLCGroup PAC ID 6103205620, 106 clinicians

Practice addresses (Care Compare)

3800 Johnson St
Suite D
Hollywood, FL 33021-6052
Phone (917) 681-4963

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS8276FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp, Inc. Anesthesiology CurrentSince Feb 1, 2023 Accepting new patients
Sheridan Healthcorp Inc Anesthesiology CurrentSince Feb 1, 2023 Accepting new patients
St. Lucie Anesthesia Associates, LLC Anesthesiology CurrentSince Feb 1, 2015 Accepting new patients
Sheridan Healthcorp Inc Anesthesiology Current Accepting new patients
St Lucie Anesthesia Associates LLC Anesthesiology CurrentSince Feb 1, 2015 Accepting new patients
Chesapeake Anesthesia Associates PA Anesthesiology Past Accepting new patients
Broad Anesthesia Associates Anesthesiology Past Accepting new patients

Locations

501 Glades Rd
Boca Raton, FL 33432
Phone (561) 362-4400

3995 NW Goldenrod Rd
Jensen Beach, FL 34957
Phone (772) 497-0020

2275 N Central Ave
Kissimmee, FL 34741
Phone (407) 570-0573

1796 US Highway 441 N
Okeechobee, FL 34972
Phone (863) 467-5222

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

2096 SE Ocean Blvd
Stuart, FL 34996
Phone (772) 223-0174

3602 Kyoto Gardens Dr
West Palm Beach, FL 33410
Phone (561) 799-2288

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1700824067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 SW BEAR PAW TRL",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349907940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1874 SE PORT ST LUCIE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525545",
            "telephone_number": "772-337-7676",
            "fax_number": "772-337-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINNICK",
        "first_name": "MAURICE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "OS8276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268945600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "37594",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.