Organization Active NPI

Amberly C Paradoa DPM PA

  • Foot & Ankle Surgery Podiatrist
  • Vero Beach, FL
National Provider Identifier
1053583856
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3105 Issued in FL
Legal business name
AMBERLY C PARADOA DPM PA
Practice address
3735 11TH Cir
Suite 201
Vero Beach, FL 32960-4844
Phone
(772) 299-7009
Fax
(772) 562-7138
NPI assigned
Apr 1, 2008
Last updated
Oct 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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

Authorized official

Name
Amberly C Paradoa, DPMNPI 1962400713
Title
President
Phone
(772) 299-7009

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
Foot & Ankle Surgery Podiatrist 213ES0103X PO3105 FL Primary

Addresses

Primary practice location

3735 11TH Cir
Suite 201
Vero Beach, FL 32960-4844

Mailing address

3735 11TH Cir
Suite 201
Vero Beach, FL 32960-4844
Phone (772) 299-7009

Other identifiers 3

IdentifierTypeStateIssuer
340483800MedicaidFL
PO3105OtherFLLICENSE
6141470001OtherFLMEDICARE DME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080619000368 FL Part B Supplier - Clinic/Group Practice 9436220365 Receives reassigned benefits from 7 practitioners
Practice locations: Sebastian, FL; Vero Beach, FL
O20100930073644 FL DME Supplier - Physician - Podiatry 9436220365 Practice locations: Vero Beach, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2164567Amberly C Paradoa DPM3735 11TH Circle Suite 201, Vero Beach, FL 32960ComplianceSep 12, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255478400000",
    "number": "1053583856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3735 11TH CIR",
            "address_2": "SUITE 201",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604844",
            "telephone_number": "772-299-7009",
            "fax_number": "772-562-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3735 11TH CIR",
            "address_2": "SUITE 201",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604844",
            "telephone_number": "772-299-7009",
            "fax_number": "772-562-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBERLY C PARADOA DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2009-10-14",
        "status": "A",
        "authorized_official_last_name": "PARADOA",
        "authorized_official_first_name": "AMBERLY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-299-7009",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340483800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PO3105",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "6141470001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.