Individual provider Active NPI

Sheron Walcott, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1003221714
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113214 Issued in FL
Practice address
255 Eastern Pkwy
Brooklyn, NY 11238
Phone
(718) 636-8291
NPI assigned
Jun 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X 017479 NY
Surgical Physician Assistant 363AS0400X 017479 NY
Physician Assistant 363A00000X PA9113214 FL Primary

Addresses

Primary practice location

255 Eastern Pkwy
Brooklyn, NY 11238

Mailing address

10712 Pacifica Way
Parkland, FL 33076-3985
Phone (347) 513-6326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150714001892 NY Practitioner - Physician Assistant 9830402239 Reassigns benefits to 11 organizations
I20230908001755 FL Practitioner - Physician Assistant 9830402239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

16040 Pines Blvd
Pembroke Pines, FL 33027-1171
Phone (954) 301-4988

195 N Federal Hwy
Suite B
Ft Lauderdale, FL 33301-1110
Phone (954) 281-9947

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501
Phone (561) 420-8555

2502 N Federal Hwy
Lighthouse Point, FL 33064-6856
Phone (954) 943-3880

2502 N State Rd
Suite 7
Hollywood, FL 33021-3205
Phone (954) 894-7955

2571 S University Dr
Davie, FL 33324-5845
Phone (561) 420-8555

3470 NW 62ND Ave
Margate, FL 33063-8311
Phone (954) 972-6868

415 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-5528
Phone (954) 457-4333

4570 Lantana Rd
Lake Worth, FL 33463-6908
Phone (561) 963-9881

4640 W Commercial Blvd
Tamarac, FL 33319-3314
Phone (954) 425-9449

6300 N Andrews Ave
Fort Lauderdale, FL 33309-2130
Phone (954) 492-2035

7007 W Broward Blvd
Unit 5
Plantation, FL 33317-2208
Phone (954) 791-3636

9650 Pines Blvd
Pembroke Pines, FL 33024-6241
Phone (954) 885-9009

9690 Glades Rd
Unit 425
Boca Raton, FL 33434-4015
Phone (561) 449-2322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017479NYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Clinic 21 of Connecticut LLC Past Accepting new patients
Pharma Holding Inc PastSince Jul 23, 2023 Accepting new patients

Locations

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: swalcott@direct.meditouchehr.com

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1003221714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10712 PACIFICA WAY",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330763985",
            "telephone_number": "347-513-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 EASTERN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11238",
            "telephone_number": "718-636-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALCOTT",
        "first_name": "SHERON",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "017479",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "017479",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.