Individual provider Active NPI

Marshall Bruce Silk, D.O.

  • Emergency Medicine Physician
  • Delray Beach, FL
National Provider Identifier
1902852486
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS6517 Issued in FL
Practice address
1690 S Congress Ave Ste 205B
Delray Beach, FL 33445-6327
Phone
(561) 459-7300
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS6517 FL Primary

Addresses

Primary practice location

1690 S Congress Ave Ste 205B
Delray Beach, FL 33445-6327

Mailing address

1314 E Las Olas Blvd
Ft Lauderdale, FL 33301-2334
Phone (954) 525-7068

Other identifiers 1

IdentifierTypeStateIssuer
269560000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
415NVMDOptometrist
OS6517FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revolutionary Care Clinic LLC CurrentSince Sep 20, 2022 Accepting new patients
Doctors ER Services, Inc. Emergency Medicine Past Accepting new patients

Locations

1690 S Congress Ave
Ste 205B
Delray Beach, FL 33445
Phone (561) 459-7300

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1902852486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 E LAS OLAS BLVD",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012334",
            "telephone_number": "954-525-7068",
            "fax_number": "305-547-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 S CONGRESS AVE STE 205B",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334456327",
            "telephone_number": "561-459-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILK",
        "first_name": "MARSHALL",
        "middle_name": "BRUCE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS6517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269560000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.