Organization Active NPI

Simona B Bartos DO PA

  • MOHS-Micrographic Surgery Physician
  • Hollywood, FL
National Provider Identifier
1821679929
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
Legal business name
SIMONA B BARTOS DO PA
Practice address
4700 Sheridan Street
Ste I
Hollywood, FL 33021-3416
Phone
(954) 937-2294
NPI assigned
Apr 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Ms. Simona B Bartos, DONPI 1174553846
Title
President
Phone
(954) 516-0722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X Primary

Addresses

Primary practice location

4700 Sheridan Street
Ste I
Hollywood, FL 33021-3416

Mailing address

4700 Sheridan Street
Ste I
Hollywood, FL 33021-3416
Phone (954) 937-2294

Other names 1

  • Imperial Dermatology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210512002425 FL Part B Supplier - Clinic/Group Practice 7315356847 Receives reassigned benefits from 2 practitioners
Practice locations: Hollywood, 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
10D2253095Simona B Bartos DO PA4700 Sheridan Street Suite I, Hollywood, FL 33021ComplianceNov 16, 2026

National Provider Directory

National Provider Directory

Locations

4700 Sheridan St
Ste I
Hollywood, FL 33021
Phone (954) 408-2020

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1821679929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 SHERIDAN STREET",
            "address_2": "STE I",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213416",
            "telephone_number": "954-937-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SHERIDAN STREET",
            "address_2": "STE I",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213416",
            "telephone_number": "954-937-2294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMONA B BARTOS DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "BARTOS",
        "authorized_official_first_name": "SIMONA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-516-0722",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imperial Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Imperial Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.