Individual provider Active NPI

Laura Lee Hartman, PA-C

  • Physician Assistant
  • Boca Raton, FL
National Provider Identifier
1003480294
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113949 Issued in FL
Practice address
1905 Clint Moore Rd Ste 309
Boca Raton, FL 33496-2661
Phone
(561) 988-8988
Fax
(561) 912-1804
NPI assigned
May 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9113949 FL Primary

Addresses

Primary practice location

1905 Clint Moore Rd Ste 309
Boca Raton, FL 33496-2661

Mailing address

1905 Clint Moore Rd Ste 309
Boca Raton, FL 33496-2661
Phone (561) 988-8988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA9113949FLMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1003480294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 CLINT MOORE RD STE 309",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962661",
            "telephone_number": "561-988-8988",
            "fax_number": "561-912-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 CLINT MOORE RD STE 309",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962661",
            "telephone_number": "561-988-8988",
            "fax_number": "561-912-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "LAURA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.