Individual provider Active NPI

Mark H Widick, MD

  • Otology & Neurotology Physician
  • Delray Beach, FL
National Provider Identifier
1871557629
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otology & Neurotology PhysicianTaxonomy code 207YX0901X
License
ME65602 Issued in FL
Practice address
5130 Linton Blvd Ste E2
Delray Beach, FL 33484-6595
Phone
(561) 391-3333
Fax
(561) 391-5618
NPI assigned
Apr 17, 2006
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME65602 FL
Otology & Neurotology Physician 207YX0901X ME65602 FL Primary

Addresses

Primary practice location

5130 Linton Blvd Ste E2
Delray Beach, FL 33484-6595

Mailing address

900 NW 13TH St
Suite 206
Boca Raton, FL 33486-2350
Phone (561) 338-3267

Other identifiers 1

IdentifierTypeStateIssuer
253536000MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050120000042 FL Practitioner - Otolaryngology 7214986983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Florida College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates of Florida, LLCGroup PAC ID 0042292849, 227 clinicians

Practice addresses (Care Compare)

900 NW 13TH St
Suite 206
Boca Raton, FL 33486-2350
Phone (561) 391-3333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME65602FLMDOtology & Neurotology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates of Florida, LLC Specialist CurrentSince Oct 31, 1997 Accepting new patients

Locations

1601 Clint Moore Rd
Ste 105
Boca Raton, FL 33487
Phone (561) 391-3333

6421 Congress Ave
Ste 113
Boca Raton, FL 33487
Phone (561) 338-3267

900 NW 13th St
Ste 206
Boca Raton, FL 33486
Phone (561) 338-3267

5130 Linton Blvd
Ste E2
Delray Beach, FL 33484
Phone (561) 495-5537

1411 N Flagler Dr
Ste 3100
West Palm Beach, FL 33401
Phone (407) 655-5562

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1871557629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 NW 13TH ST",
            "address_2": "SUITE 206",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862350",
            "telephone_number": "561-338-3267",
            "fax_number": "561-391-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 LINTON BLVD STE E2",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846595",
            "telephone_number": "561-391-3333",
            "fax_number": "561-391-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDICK",
        "first_name": "MARK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME65602",
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "FL",
            "license": "ME65602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253536000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.