Individual provider Active NPI

Carolina Nelson, PA-C

  • Physician Assistant
  • Boca Raton, FL
National Provider Identifier
1013620921
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9119674 Issued in FL
Practice address
9970 Central Park Blvd N Ste 101
Boca Raton, FL 33428-2237
Phone
(561) 488-2700
Fax
(877) 258-1237
NPI assigned
Jan 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9119674 FL Primary
Physician Assistant 363A00000X 12591 GA
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

9970 Central Park Blvd N Ste 101
Boca Raton, FL 33428-2237

Mailing address

9500 S Dadeland Blvd Ste 200
Miami, FL 33156-2866

Other practice location 1

1825 Highway 34 E Ste 1200
Newnan, GA 30265-6416
Phone (800) 362-3632

Other practice location 2

3200 S University Dr
Davie, FL 33328-2018
Phone (954) 262-1250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, 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
I20241125001564 GA Practitioner - Physician Assistant 0547795700
I20251105004733 FL Practitioner - Physician Assistant 0547795700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nova Southeastern College of Osteo Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastro Health, LLCGroup PAC ID 2365440567, 246 clinicians

Practice addresses (Care Compare)

9970 Central Park Blvd N
Suite 101
Boca Raton, FL 33428-2237
Phone (561) 488-2700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12591GAMDDiagnostic Radiology Physician
PA9119674FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro Health, LLC CurrentSince Dec 8, 2025 Accepting new patients
Gastro Health LLC Current Accepting new patients

Locations

9970 Central Park Blvd N
Ste 101
Boca Raton, FL 33428
Phone (561) 488-2700

4675 Linton Blvd
Ste 202
Delray Beach, FL 33445
Phone (561) 495-5700

9500 S Dadeland Blvd
Ste 200
Miami, FL 33156
Phone (786) 530-3820

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1013620921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 S DADELAND BLVD STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9970 CENTRAL PARK BLVD N STE 101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334282237",
            "telephone_number": "561-488-2700",
            "fax_number": "877-258-1237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1825 Highway 34 E Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302656416",
            "country_code": "US",
            "telephone_number": "800-362-3632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 S University Dr",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333282018",
            "country_code": "US",
            "telephone_number": "954-262-1250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CAROLINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-05",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9119674",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12591",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.