Individual provider Active NPI

Marlene Chris Machado, PA-C

  • Medical Physician Assistant
  • Hialeah, FL
National Provider Identifier
1013244755
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9102958 Issued in FL
Practice address
4578 W 12TH Ave
Hialeah, FL 33012-3325
Phone
(053) 828-1989
NPI assigned
Nov 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9102958 FL Primary

Addresses

Primary practice location

4578 W 12TH Ave
Hialeah, FL 33012-3325

Mailing address

15951 SW 6TH St
Pembroke Pines, FL 33027-1161
Phone (305) 467-4217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050126000594 FL Practitioner - Physician Assistant 3476502204 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Las Mercedes, LLC CurrentSince Nov 12, 2024 Accepting new patients
Clinica Las Mercedes, LLC CurrentSince Nov 12, 2024 Accepting new patients
Retina Macula Specialists of Miami LLC Past Accepting new patients

Locations

1479 NW 27th Ave
Miami, FL 33125
Phone (305) 633-3776

8251 W Broward Blvd
Ste 200210
Plantation, FL 33324
Phone (954) 334-3131

6355 NW 36th St
Ste 1100
Virginia Gardens, FL 33166

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1013244755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15951 SW 6TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271161",
            "telephone_number": "305-467-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4578 W 12TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123325",
            "telephone_number": "053-828-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHADO",
        "first_name": "MARLENE",
        "middle_name": "CHRIS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-16",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.