NPIMap

Organization Active NPI

Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Summerfield, FL
National Provider Identifier
1861976516
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
FLORIDA CLINICAL PRACTICE ASSOCIATION INC
Practice address
10435 SE 170TH PL
Summerfield, FL 34491-8998
Phone
(352) 259-5658
NPI assigned
Sep 19, 2018
Last updated
Sep 19, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
FLORIDA CLINICAL PRACTICE ASSOCIATION INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Authorized official

Name
Jeremy Sibiski
Title
Executive Director of Fin & Admin
Phone
(352) 265-8017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

10435 SE 170TH PL
Summerfield, FL 34491-8998

Mailing address

PO Box 13833
Philadelphia, PA 19101-3833

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181029000715 FL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0345146254 Practice locations: The Villages, FL

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Salvatorer Goodwin MD33 organizations share this tax ID, including this one
Part of
Salvatorer Goodwin MD

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537315200000",
    "number": "1861976516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13833",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191013833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10435 SE 170TH PL",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918998",
            "telephone_number": "352-259-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA CLINICAL PRACTICE ASSOCIATION INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA CLINICAL PRACTICE ASSOCIATION INC",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A",
        "authorized_official_last_name": "SIBISKI",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF FIN & ADMIN",
        "authorized_official_telephone_number": "352-265-8017"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerfield, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.