Siwicki & Ricciardi,P.L.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

P01110 & P02964 Issued in FL

Legal business name

SIWICKI & RICCIARDI,P.L.

Practice address

120 E Redstone Ave Ste a
Crestview, FL 32539-5370

Phone

(850) 682-6522

NPI assigned

Jan 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Cosimo A Ricciardi, D.P.M.

Title

Ceo

Phone

(850) 862-4119

Specialties & licenses 1

Addresses

Other names 1

• Emerald Coast Podiatry & Wound Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Siwicki & Ricciardi,P.L.

  • Podiatrist
  • Fort Walton Beach, FL
  • NPI 1265472211

  4385647619

  Same PAC ID

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553558400000",
    "number": "1790961514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914A MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476706",
            "telephone_number": "850-862-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E REDSTONE AVE STE A",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395370",
            "telephone_number": "850-682-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIWICKI & RICCIARDI,P.L.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2019-03-26",
        "status": "A",
        "authorized_official_last_name": "RICCIARDI",
        "authorized_official_first_name": "COSIMO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-862-4119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "P01110 & P02964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerald Coast Podiatry & Wound Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Emerald Coast Podiatry & Wound Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Silvercrest Operating Investments LLC
• Shawn Victor Sima, PA-C
• Cheyenne Carol Simmons
• Lauren Simon Sejan, DMD
• Zaria Singleton-Ledet
• Alyssa Slattery, WHNP-BC
• Jared Steven Sleeman, IDMT
• Sarah Slimski
• Kelly Smidebush, ARNP
• Alexa Smith, RBT

• Podiatrist in Crestview, FL
• Providers in Crestview, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.