Individual provider Active NPI

Samuel S Woociker, DPM

  • Podiatrist
  • Orlando, FL
National Provider Identifier
1912971979
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO 1323 Issued in FL
Practice address
2014 S Orange Ave
Suite 100
Orlando, FL 32806-3069
Phone
(407) 423-1234
Fax
(407) 517-1040
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO 1323 FL Primary

Addresses

Primary practice location

2014 S Orange Ave
Suite 100
Orlando, FL 32806-3069

Mailing address

445 Warrior TRL
Enterprise, FL 32725-2456
Phone (407) 376-0522

Other identifiers 2

IdentifierTypeStateIssuer
041065900MedicaidFL
P00099490OtherFLR/R MEDICARE

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040326000219 FL Practitioner - Podiatry 0749172682 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

445 Warrior TRL
Enterprise, FL 32725-2456
Phone (407) 376-0522

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue409
Removal or shaving of skin growth133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO 1323FLMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
D.H. Medical, LLC CurrentSince Jul 15, 2020 Accepting new patients
Pedirite Medical FL LLC CurrentSince Jan 15, 2022 Accepting new patients
Samuel S Woociker DPM PA CurrentSince Dec 20, 2019 Accepting new patients
Central Florida Family Health Center, Inc. Past Accepting new patients

Locations

60 N US Highway 17 92
Debary, FL 32713
Phone (386) 668-4426

226 N Nova Rd
Ormond Beach, FL 32174
Phone (386) 235-1489

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

Organizations & group practices 4

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1912971979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 WARRIOR TRL",
            "city": "ENTERPRISE",
            "state": "FL",
            "postal_code": "327252456",
            "telephone_number": "407-376-0522",
            "fax_number": "407-386-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 S ORANGE AVE",
            "address_2": "SUITE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328063069",
            "telephone_number": "407-423-1234",
            "fax_number": "407-517-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOCIKER",
        "first_name": "SAMUEL",
        "middle_name": "S",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO 1323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041065900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE",
            "identifier": "P00099490",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.