MEMORIAL DIVISION OF OTOLARYNGOLOGY – Otolaryngology Physician, NPI 1457798704
Otolaryngology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MEMORIAL DIVISION OF OTOLARYNGOLOGY
603 N Flamingo Rd Ste 151
Pembroke Pines, FL 330281021
Phone: (954) 265-2750
Fax: (954) 276-0217
Type: Location
1150 N 35th Ave Ste 670
Hollywood, FL 330215435
Phone: (954) 265-1700
Fax: (954) 276-0623
Type: Location
1971 SW 172nd Ave Ste 2300
Miramar, FL 330295625
Phone: (954) 265-2750
Fax: (954) 893-6323
Type: Location
2900 CORPORATE WAY
DOOR D
MIRAMAR, FL 330253925
Phone: (954) 276-5685
Fax: (954) 985-7074
Type: Mailing
1150 N 35TH AVE STE 540
HOLLYWOOD, FL 33021
Phone: (954) 265-2750
Fax: (954) 893-6323
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: 2013-12-04
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 |
|---|---|---|---|---|
| O20131204000401 | 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 33028)
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