Randy Scott Kimmelman, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

OS7449 Issued in FL

Practice address

3467 W Hillsboro Blvd
Suite B
Deerfield Beach, FL 33442-9473

Phone

(954) 574-0252

Fax

(954) 429-1759

NPI assigned

Aug 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

General Surgery

Education

Rowan University School of Osteopathic Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Florida Surgical Specialists LLCGroup PAC ID 5799881660, 91 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168
• Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073
• West Boca Medical Center Hospital, Boca Raton, FL, CCN 100268

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: randykimmelman@sfssllc.allscriptsdirect.net

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.

• South Florida Surgical Specialists LLC

  • Surgery Physician
  • Coral Springs, FL
  • NPI 1952409963
  Medicare reassignment Care Compare group NPD
• Jersey Surgery, P.L.

  • Surgery Physician
  • Deerfield Beach, FL
  • NPI 1184643322
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Boca Raton Regional Hospital, Inc.

  • General Acute Care Hospital
  • Boca Raton, FL
  • NPI 1902826779
  Care Compare affiliation
• Holy Cross Hospital Inc

  • Internal Medicine Physician
  • Ft. Lauderdale, FL
  • NPI 1467401877

  Hospital

  Care Compare affiliation
• Holy Cross Hospital Inc

  • General Acute Care Hospital
  • Ft Lauderdale, FL
  • NPI 1639197395
  Care Compare affiliation
• Holy Cross Hospital, Inc.

  • Urgent Care Clinic/Center
  • Boca Raton, FL
  • NPI 1376953125

  Hospital

  Care Compare affiliation
• Holy Cross Hospital, Inc.

  • Urgent Care Clinic/Center
  • Fort Lauderdale, FL
  • NPI 1386985190

  Hospital

  Care Compare affiliation
• West Boca Medical Center, Inc.

  • General Acute Care Hospital
  • Boca Raton, FL
  • NPI 1588697296
  Care Compare affiliation

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1730192964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3467 W HILLSBORO BLVD",
            "address_2": "SUITE B",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334429473",
            "telephone_number": "954-574-0252",
            "fax_number": "954-429-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3467 W HILLSBORO BLVD",
            "address_2": "SUITE B",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334429473",
            "telephone_number": "954-574-0252",
            "fax_number": "954-429-1759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 W Cocoa Beach Cswy",
            "address_purpose": "LOCATION",
            "city": "Cocoa Beach",
            "state": "FL",
            "postal_code": "329315595",
            "country_code": "US",
            "telephone_number": "321-868-5871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMMELMAN",
        "first_name": "RANDY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS7449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252588700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - FL",
            "identifier": "57516U",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "57516",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "241859",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherri Kidd
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• Rebekah Kieffer
• Lauren Kile
• Wendy Kilroy
• Hillary Kinchen
• Briana Kincherlow, LMRT, MA, RBT
• Cherisse King, PHARMD
• Dequane King
• Joshenaye Avery Rene King

• Surgery Physician in Deerfield Beach, FL
• Providers in Deerfield Beach, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.