Robert David Siwicki, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PO1110 Issued in FL

Practice address

914A Mar Walt Dr
Fort Walton Beach, FL 32547-6606

Phone

(850) 862-4119

Fax

(850) 862-5470

NPI assigned

Dec 20, 2005

Last updated

Sep 26, 2012By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Robert D. Siwicki,D.P.M.,P.a.

  dba Emerald Coast Podiatry & Wound Care Center

  • Podiatrist
  • Fort Walton Beach, FL
  • NPI 1649256348
  Authorized official Same address or phone
• Siwicki & Ricciardi,P.L.

  dba Emerald Coast Podiatry & Wound Care Center

  • Podiatrist
  • Fort Walton Beach, FL
  • NPI 1265472211
  NPD (past)
• Siwicki & Ricciardi PL

  dba Emerald Coast Podiatry

  • Foot & Ankle Surgery Podiatrist
  • Andalusia, AL
  • NPI 1295197093
  NPD (past)

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1881670081",
    "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",
            "fax_number": "850-862-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914A MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476606",
            "telephone_number": "850-862-4119",
            "fax_number": "850-862-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIWICKI",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO1110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041128100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PALMETTO GBA",
            "identifier": "CN7984",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Michelle Sims
• Poorita Mitra Singh, FNP-C
• Katrina Alfreda Intrepido Single, APRN
• John David Sites, M.D.
• Siwicki & Ricciardi,P.L. (Emerald Coast Podiatry & Wound Care Center)
• Skillsource, Inc.
• Timothy David Skinner, AU.D.
• Sarah Skipper
• Teresa Marie Skojac, MD
• Katherine Nicole Skraba, PA

• Podiatrist in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.