Organization Active NPI

Spine Institute of South Florida PA

  • Orthopaedic Surgery of the Spine Physician
  • Delray Beach, FL
National Provider Identifier
1700970126
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
SPINE INSTITUTE OF SOUTH FLORIDA PA
Practice address
5210 Linton Blvd
Suite 103
Delray Beach, FL 33484-6542
Phone
(561) 381-4271
Fax
(561) 381-4273
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Authorized official

Name
Susan G Davis
Title
Manager
Phone
(561) 381-4271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X Primary

Addresses

Primary practice location

5210 Linton Blvd
Suite 103
Delray Beach, FL 33484-6542

Mailing address

5210 Linton Blvd
Suite 103
Delray Beach, FL 33484-6542
Phone (561) 381-4271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040810000182 FL Part B Supplier - Clinic/Group Practice 3870565963 Receives reassigned benefits from 6 practitioners
Practice locations: Boca Raton, FL; Palm Beach Gardens, FL; Delray Beach, FL
O20100930095534 FL DME Supplier - Physician - General Practice 3870565963 Practice locations: Delray Beach, 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
10D2117202Spine Institute of South Florida5210 Linton Blvd Ste 103, Delray Beach, FL 33484Certificate of waiverAug 9, 2026

National Provider Directory

National Provider Directory

Locations

5210 Linton Blvd
Ste 103
Delray Beach, FL 33484
Phone (561) 381-4271

Practitioners & affiliated clinicians

Practitioners 6

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1700970126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 LINTON BLVD",
            "address_2": "SUITE 103",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846542",
            "telephone_number": "561-381-4271",
            "fax_number": "561-381-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5210 LINTON BLVD",
            "address_2": "SUITE 103",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846542",
            "telephone_number": "561-381-4271",
            "fax_number": "561-381-4273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE INSTITUTE OF SOUTH FLORIDA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-381-4271"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.