Individual provider Active NPI

Adib Antoine Chidiac, M.D., P.A., FACOG

  • Specialist
  • Pompano Beach, FL
National Provider Identifier
1932162682
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0043336 Issued in FL
Practice address
1600 N Federal Hwy Ste a
Pompano Beach, FL 33062-3229
Phone
(954) 366-6039
Fax
(954) 366-6851
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0043336 FL Primary

Addresses

Primary practice location

1600 N Federal Hwy Ste a
Pompano Beach, FL 33062-3229

Mailing address

PO Box 50461
Lighthouse Point, FL 33074-0461
Phone (954) 366-6039

Other identifiers 1

IdentifierTypeStateIssuer
370810100MedicaidFL

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
I20121005000176 FL Practitioner - Obstetrics/Gynecology 8921141888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

601 E Sample Rd
Suite 103
Deerfield Beach, FL 33064-4443
Phone (954) 366-6039

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adib Antoine Chidiac, M.D., P.a. Specialist CurrentSince Dec 5, 1983 Accepting new patients
OB Hospitalist Group LLC Current Accepting new patients
OB Hospitalist Group LLC CurrentSince Jan 16, 2022 Accepting new patients
OB Hospitalist Group LLC CurrentSince Jan 16, 2022 Accepting new patients
New Life Maternity and Womens Center Past Accepting new patients

Locations

601 E Sample Rd
Ste 103
Deerfield Beach, FL 33064
Phone (954) 366-6039

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

2100 NE 36th St
Ste 201
Lighthouse Point, FL 33064
Phone (954) 781-0180

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

1600 N Federal Hwy
#A
Pompano Beach, FL 33062
Phone (754) 234-0984

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Interoperability endpoints

  • Direct secure messaging: anthony.chidiac.1@28703.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1932162682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50461",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330740461",
            "telephone_number": "954-366-6039",
            "fax_number": "954-366-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N FEDERAL HWY STE A",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330623229",
            "telephone_number": "954-366-6039",
            "fax_number": "954-366-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIDIAC",
        "first_name": "ADIB",
        "middle_name": "ANTOINE",
        "name_prefix": "Mr.",
        "credential": "M.D., P.A., FACOG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0043336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370810100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.