Memorial Division of Pediatric Orthopedics – Pediatric Orthopaedic Surgery Physician, NPI 1407865520
Pediatric Orthopaedic Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Memorial Division of Pediatric Orthopedics
1150, North 35th Avenue, West Hollywood, Hollywood, Broward County, Florida, 33021, United States
SUITE 345
HOLLYWOOD, FL 330215424
Phone: (954) 265-6300
Fax: (954) 961-3600
Type: Location
9291 Glades Rd Ste 202
Boca Raton, FL 334343959
Phone: (954) 265-6300
Fax: (954) 961-3600
Type: Location
1865 N Corporate Lakes Blvd Ste 1
Weston, FL 333263273
Phone: (954) 265-6300
Fax: (954) 961-3600
Type: Location
3377 S Sate Rd 7
Suite 100
Wellington, FL 33449
Phone: (561) 341-7000
Fax: (561) 784-7098
Type: Location
5830 Coral Ridge Dr Ste 207
Coral Springs, FL 330763388
Phone: (954) 265-6300
Fax: (954) 961-3600
Type: Location
1971 SW 172nd Ave Ste 2600
Miramar, FL 330295627
Phone: (954) 265-6300
Fax: (954) 961-3600
Type: Location
2900, Corporate Way, Miramar, Broward County, Florida, 33025, United States
DOOR D
MIRAMAR, FL 330253925
Phone: (954) 276-5644
Fax: (954) 276-0668
Type: Mailing
3440 HOLLYWOOD BLVD STE 140
HOLLYWOOD, FL 330216900
Phone: (954) 265-6300
Fax: (954) 961-3600
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-08-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20070824000241 | O | Clinic/Group Practice | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33021)
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