Organization Active NPI

Professional Surgical Services PLLC

  • Surgical Physician Assistant
  • Hialeah, FL
National Provider Identifier
1033302641
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9101660 Issued in FL
Legal business name
PROFESSIONAL SURGICAL SERVICES PLLC
Practice address
8814 NW 180TH Ter
Hialeah, FL 33018-6503
Phone
(786) 390-4789
NPI assigned
Aug 27, 2007
Last updated
Dec 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Authorized official

Name
Nasser Dabien, PANPI 1588723373
Title
President
Phone
(786) 390-4789

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9101660 FL Primary

Addresses

Primary practice location

8814 NW 180TH Ter
Hialeah, FL 33018-6503

Mailing address

8814 NW 180TH Ter
Hialeah, FL 33018-6503
Phone (786) 390-4789

Other identifiers 1

IdentifierTypeStateIssuer
291175200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080205000556 FL Part B Supplier - Clinic/Group Practice 6608959200 Receives reassigned benefits from 6 practitioners
Practice locations: Hollywood, FL; Miramar, FL; Pembroke Pines, FL; South Miami, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324512000000",
    "number": "1033302641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8814 NW 180TH TER",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330186503",
            "telephone_number": "786-390-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8814 NW 180TH TER",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330186503",
            "telephone_number": "786-390-4789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL SURGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2011-12-22",
        "status": "A",
        "authorized_official_last_name": "DABIEN",
        "authorized_official_first_name": "NASSER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-390-4789",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9101660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291175200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.