Individual provider Active NPI

Naomie Duvelsaint

  • Physician Assistant
  • Royal Palm Beach, FL
National Provider Identifier
1003693581
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9594 Issued in AZ
Practice address
180 Kensington Way
Royal Palm Beach, FL 33414-4314
Phone
(781) 354-8947
NPI assigned
Sep 11, 2023
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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 9594 AZ Primary

Addresses

Primary practice location

180 Kensington Way
Royal Palm Beach, FL 33414-4314

Mailing address

180 Kensington Way
Royal Palm Beach, FL 33414-4314
Phone (781) 354-8947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240311000350 AZ Practitioner - Physician Assistant 6002252269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitiello Primary Care PLLCGroup PAC ID 8628448263, 2 clinicians

Practice addresses (Care Compare)

21300 N John Wayne Pkwy
Suite 108
Maricopa, AZ 85139-8964
Phone (520) 568-5963

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence General Medicine, PC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1003693581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 KENSINGTON WAY",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334144314",
            "telephone_number": "781-354-8947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 KENSINGTON WAY",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334144314",
            "telephone_number": "781-354-8947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVELSAINT",
        "first_name": "NAOMIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.